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2942 - The role of pre-treatment plasma Epstein-Barr virus (EBV) DNA as a predictive biomarker of induction chemotherapy for stage IVA or IVB nasopharyngeal carcinoma (NPC) patients – A Subgroup Analysis on Taiwan Cooperative Oncology Group (TCOG) 1303 study


09 Oct 2016


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Hsiang-Fong Kao


Annals of Oncology (2016) 27 (6): 328-350. 10.1093/annonc/mdw376


H. Kao1, C. Hsiao2, S. Lai2, C. Wang1, J. Ko3, P. Lo3, T. Lee1, T. Liu4, R. Hong1

Author affiliations

  • 1 Department Of Oncology, National Taiwan University Hospital, 100 - Taipei/TW
  • 2 Institute Of Population Health Sciences, National Health Research Institutes, 35053 - Miao-Li/TW
  • 3 Department Of Otorhinolaryngology, National Taiwan University Hospital, 100 - Taipei/TW
  • 4 National Health Research Institutes, Taiwan Cooperative Oncology Group, 115 - Taipei/TW


Abstract 2942


Pre-treatment plasma EBV DNA is considered as a prognostic biomarker for NPC patients. Whether the pre-treatment EBV DNA could be a biomarker guiding the treatment for advanced NPC patients warrants investigation.


TCOG 1303 was a phase III trial comparing induction chemotherapy (IC) followed by concurrent chemoradiation (CCRT) versus CCRT alone in stage IVA or IVB NPC patients. In both arms, radiotherapy would be delivered with weekly cisplatin (30mg/m2). For patients in IC arm, chemotherapy with mitomycin C, epirubicin, cisplatin, 5-fluorouracil, and leucovorin were administered for 3 cycles before the CCRT. The primary endpoint was disease free survival. Pre-treatment plasma EBV DNA was analyzed.


From September 2003 to August 2009, 479 patients were enrolled. The pre-treatment plasma EBV DNA were collected from 264 patients. The median follow-up were 66 months. The median of plasma EBV DNA was 7862.5 copies/mL. 135 pts were grouped in EBV DNA =  8000 copies/mL (EBV-high). High plasma EBV DNA is statistically significant with larger tumor size (p 


Pre-treatment plasma EBV DNA cannot be a biomarker of induction MEPFL for stage IVA or IVB NPC patients. The biology role of pre-treatment EBV DNA should be explored.

Clinical trial identification


Legal entity responsible for the study

Hsiang-Fong Kao


National Taiwan University Hospital, Taiwan National Health Research Institutes, Taiwan


All authors have declared no conflicts of interest.

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