title: Remarkable application of serum EBV EBER-1 in monitoring response of nasopharyngeal cancer patients to salvage chemotherapy.
abstract: Nineteen consecutive patients with metastatic or recurrent nasopharyngeal cancer (NPC) receiving combination chemotherapy were monitored for EBV DNA in their serum. EBV DNA (EBER-1) concentration in serum was measured before, during, and after chemotherapy. Thirteen patients had additional multiple prechemotherapy readings. There was a significant lead time from first detection of serum EBER-1 to clinical recurrence in 62% of patients by a mean of 17.4 weeks (range: 8-74.5 weeks; mean = 28.2 weeks if confined to the 8 patients with significant lead time). The median EBER-1 concentration was significantly higher in those with distant metastasis as compared to those with loco-regional recurrence only (17,468 vs. 684 pg/mL serum; p = 0.046, Mann-Whitney U test). Among the 13 patients who responded to chemotherapy, 4 exhibited clinical complete remission (CR) who were only found in the group with EBER-1 DNA drop to background level, while the magnitude of EBER-1 drop did not discriminate partial remission (PR) and stable disease (SD) patients clearly. Subsequent profile of EBER-1 DNA showed concordance with clinical course of either continuous remission or later progression. EBER-1 DNA in serum can become a useful adjunctive surrogate marker to monitor chemotherapeutic response in NPC patients with distant metastasis or advanced local recurrence.
authors.affiliation: Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China. nkcroger@hknet.com
authors.forename: R K
authors.initials: RK
authors.lastname: Ngan
authors.forename: W H
authors.initials: WH
authors.lastname: Lau
authors.forename: T T
authors.initials: TT
authors.lastname: Yip
authors.forename: W C
authors.initials: WC
authors.lastname: Cho
authors.forename: W W
authors.initials: WW
authors.lastname: Cheng
authors.forename: C K
authors.initials: CK
authors.lastname: Lim
authors.forename: K K
authors.initials: KK
authors.lastname: Wan
authors.forename: E
authors.initials: E
authors.lastname: Chu
authors.forename: I
authors.initials: I
authors.lastname: Joab
authors.forename: V
authors.initials: V
authors.lastname: Grunewald
authors.forename: Y F
authors.initials: YF
authors.lastname: Poon
authors.forename: J H
authors.initials: JH
authors.lastname: Ho
mesh_terms: D004279:DNA, Viral / Q000097:blood; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D008991:Monitoring, Physiologic; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D012367:RNA, Viral / Q000097:blood*; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral; C099537:Epstein-Barr virus encoded RNA 1; D012367:RNA, Viral