Comparison of Clinical and Molecular Surveillance in Patients with Advanced Nasopharyngeal Carcinoma after Primary Therapy: The Potential Role of Quantitative Analysis of Circulating Epstein-Barr Virus DNA

Ruey Long Hong, Chin Yu Lin, Lai Lei Ting, Jenq Yuh Ko, Mow Ming Hsu

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND. The importance of detecting recurrence at an early stage in patients with malignant disease is well recognized. Circulating Epstein-Barr virus (EBV) DNA can be detected in patients with nasopharyngeal carcinoma (NPC). The objective of the current study was to assess the effectiveness of plasma EBV DNA monitoring in the early detection of NPC recurrence compared with conventional methods. METHODS. Patients with NPC in two prospective clinical trials who had locoregional recurrences or distant metastases were recruited into the study. Clinical data on these patients were scrutinized for evidence of recurrence. EBV DNA copy numbers in the prospectively collected plasma samples were assayed retrospectively with real-time quantitative polymerase chain reaction analysis. RESULTS. At the time of clinical recurrence, 65% of 26 patients with locoregional recurrences and all but 1 of 28 patients with distant failure had circulating EBV DNA. The difference between the time from completion of treatment to positivity for circulating EBV DNA and the time from completion of treatment to the first observed clinical abnormality was not statistically significant for patients with local recurrence (P = 0.84). However, the time to the first detection of circulating EBV DNA was significantly shorter among patients with distant metastases (P < 0.0001). The Kaplan-Meier estimated median time to the emergence of plasma EBV DNA was 190 days, with a 95% confidence interval (CI) of 95-300 days, and the median time to the first observed clinical abnormality was 295 days (95% CI, 276-361 days). CONCLUSIONS. Monitoring plasma EBV DNA levels surpassed traditional methods for the early detection of distant failure in patients with NPC. The role of this technique should be evaluated in prospective studies that incorporate complementary advanced imaging technology.

Original languageEnglish
Pages (from-to)1429-1437
Number of pages9
JournalCancer
Volume100
Issue number7
DOIs
Publication statusPublished - Apr 1 2004
Externally publishedYes

Fingerprint

Human Herpesvirus 4
DNA
Recurrence
Therapeutics
Confidence Intervals
Neoplasm Metastasis
Nasopharyngeal carcinoma
Real-Time Polymerase Chain Reaction
Clinical Trials
Prospective Studies
Technology

Keywords

  • Cancer detection
  • Distant metastasis
  • Lactate dehydrogenase
  • Polymerase chain reaction

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Comparison of Clinical and Molecular Surveillance in Patients with Advanced Nasopharyngeal Carcinoma after Primary Therapy : The Potential Role of Quantitative Analysis of Circulating Epstein-Barr Virus DNA. / Hong, Ruey Long; Lin, Chin Yu; Ting, Lai Lei; Ko, Jenq Yuh; Hsu, Mow Ming.

In: Cancer, Vol. 100, No. 7, 01.04.2004, p. 1429-1437.

Research output: Contribution to journalArticle

@article{c77478f6a5034a138fb2b873bf20b407,
title = "Comparison of Clinical and Molecular Surveillance in Patients with Advanced Nasopharyngeal Carcinoma after Primary Therapy: The Potential Role of Quantitative Analysis of Circulating Epstein-Barr Virus DNA",
abstract = "BACKGROUND. The importance of detecting recurrence at an early stage in patients with malignant disease is well recognized. Circulating Epstein-Barr virus (EBV) DNA can be detected in patients with nasopharyngeal carcinoma (NPC). The objective of the current study was to assess the effectiveness of plasma EBV DNA monitoring in the early detection of NPC recurrence compared with conventional methods. METHODS. Patients with NPC in two prospective clinical trials who had locoregional recurrences or distant metastases were recruited into the study. Clinical data on these patients were scrutinized for evidence of recurrence. EBV DNA copy numbers in the prospectively collected plasma samples were assayed retrospectively with real-time quantitative polymerase chain reaction analysis. RESULTS. At the time of clinical recurrence, 65{\%} of 26 patients with locoregional recurrences and all but 1 of 28 patients with distant failure had circulating EBV DNA. The difference between the time from completion of treatment to positivity for circulating EBV DNA and the time from completion of treatment to the first observed clinical abnormality was not statistically significant for patients with local recurrence (P = 0.84). However, the time to the first detection of circulating EBV DNA was significantly shorter among patients with distant metastases (P < 0.0001). The Kaplan-Meier estimated median time to the emergence of plasma EBV DNA was 190 days, with a 95{\%} confidence interval (CI) of 95-300 days, and the median time to the first observed clinical abnormality was 295 days (95{\%} CI, 276-361 days). CONCLUSIONS. Monitoring plasma EBV DNA levels surpassed traditional methods for the early detection of distant failure in patients with NPC. The role of this technique should be evaluated in prospective studies that incorporate complementary advanced imaging technology.",
keywords = "Cancer detection, Distant metastasis, Lactate dehydrogenase, Polymerase chain reaction",
author = "Hong, {Ruey Long} and Lin, {Chin Yu} and Ting, {Lai Lei} and Ko, {Jenq Yuh} and Hsu, {Mow Ming}",
year = "2004",
month = "4",
day = "1",
doi = "10.1002/cncr.20129",
language = "English",
volume = "100",
pages = "1429--1437",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

TY - JOUR

T1 - Comparison of Clinical and Molecular Surveillance in Patients with Advanced Nasopharyngeal Carcinoma after Primary Therapy

T2 - The Potential Role of Quantitative Analysis of Circulating Epstein-Barr Virus DNA

AU - Hong, Ruey Long

AU - Lin, Chin Yu

AU - Ting, Lai Lei

AU - Ko, Jenq Yuh

AU - Hsu, Mow Ming

PY - 2004/4/1

Y1 - 2004/4/1

N2 - BACKGROUND. The importance of detecting recurrence at an early stage in patients with malignant disease is well recognized. Circulating Epstein-Barr virus (EBV) DNA can be detected in patients with nasopharyngeal carcinoma (NPC). The objective of the current study was to assess the effectiveness of plasma EBV DNA monitoring in the early detection of NPC recurrence compared with conventional methods. METHODS. Patients with NPC in two prospective clinical trials who had locoregional recurrences or distant metastases were recruited into the study. Clinical data on these patients were scrutinized for evidence of recurrence. EBV DNA copy numbers in the prospectively collected plasma samples were assayed retrospectively with real-time quantitative polymerase chain reaction analysis. RESULTS. At the time of clinical recurrence, 65% of 26 patients with locoregional recurrences and all but 1 of 28 patients with distant failure had circulating EBV DNA. The difference between the time from completion of treatment to positivity for circulating EBV DNA and the time from completion of treatment to the first observed clinical abnormality was not statistically significant for patients with local recurrence (P = 0.84). However, the time to the first detection of circulating EBV DNA was significantly shorter among patients with distant metastases (P < 0.0001). The Kaplan-Meier estimated median time to the emergence of plasma EBV DNA was 190 days, with a 95% confidence interval (CI) of 95-300 days, and the median time to the first observed clinical abnormality was 295 days (95% CI, 276-361 days). CONCLUSIONS. Monitoring plasma EBV DNA levels surpassed traditional methods for the early detection of distant failure in patients with NPC. The role of this technique should be evaluated in prospective studies that incorporate complementary advanced imaging technology.

AB - BACKGROUND. The importance of detecting recurrence at an early stage in patients with malignant disease is well recognized. Circulating Epstein-Barr virus (EBV) DNA can be detected in patients with nasopharyngeal carcinoma (NPC). The objective of the current study was to assess the effectiveness of plasma EBV DNA monitoring in the early detection of NPC recurrence compared with conventional methods. METHODS. Patients with NPC in two prospective clinical trials who had locoregional recurrences or distant metastases were recruited into the study. Clinical data on these patients were scrutinized for evidence of recurrence. EBV DNA copy numbers in the prospectively collected plasma samples were assayed retrospectively with real-time quantitative polymerase chain reaction analysis. RESULTS. At the time of clinical recurrence, 65% of 26 patients with locoregional recurrences and all but 1 of 28 patients with distant failure had circulating EBV DNA. The difference between the time from completion of treatment to positivity for circulating EBV DNA and the time from completion of treatment to the first observed clinical abnormality was not statistically significant for patients with local recurrence (P = 0.84). However, the time to the first detection of circulating EBV DNA was significantly shorter among patients with distant metastases (P < 0.0001). The Kaplan-Meier estimated median time to the emergence of plasma EBV DNA was 190 days, with a 95% confidence interval (CI) of 95-300 days, and the median time to the first observed clinical abnormality was 295 days (95% CI, 276-361 days). CONCLUSIONS. Monitoring plasma EBV DNA levels surpassed traditional methods for the early detection of distant failure in patients with NPC. The role of this technique should be evaluated in prospective studies that incorporate complementary advanced imaging technology.

KW - Cancer detection

KW - Distant metastasis

KW - Lactate dehydrogenase

KW - Polymerase chain reaction

UR - http://www.scopus.com/inward/record.url?scp=1642389377&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=1642389377&partnerID=8YFLogxK

U2 - 10.1002/cncr.20129

DO - 10.1002/cncr.20129

M3 - Article

C2 - 15042677

AN - SCOPUS:1642389377

VL - 100

SP - 1429

EP - 1437

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 7

ER -