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
National Taiwan University Hospital, Taiwan National Health Research Institutes, Taiwan
All authors have declared no conflicts of interest.