Combined Real-time Liquid Biopsy with TNM Stage to Guide Induction Chemotherapy Cycles in Nasopharyngeal Carcinoma: A Development and Validation Study - PubMed
4 hours ago
- #induction chemotherapy
- #nasopharyngeal carcinoma
- #liquid biopsy
- Study proposes combining TNM stage with post-cycle-two plasma EBV DNA status to guide induction chemotherapy (IC) cycles in locally advanced nasopharyngeal carcinoma (LA-NPC).
- Training cohort (794 patients) and external validation cohort (448 patients) were used, with patients receiving 2-3 IC cycles plus (chemo-)radiotherapy.
- Recursive partitioning analysis stratified patients into three prognostic groups based on post-IC2-EBV-DNA status and TNM stage.
- Low-risk group (undetectable EBV-DNA) showed no FFS difference between two- and three-cycle IC (83.8% vs 87.3%, p=0.647).
- High-risk group (stage IVA with detectable EBV-DNA) benefited from a third IC cycle (74.0% vs 56.8% FFS, p=0.013).
- Intermediate-risk group (stage III with detectable EBV-DNA) showed no significant FFS difference between two- and three-cycle IC (75.9% vs 83.1%, p=0.269).
- Findings were confirmed in the external validation cohort.
- Conclusion: Stage IVA LA-NPC patients with detectable EBV-DNA after two IC cycles benefit from a third cycle, while stage III or undetectable EBV-DNA patients do not.