Year: 2025
Type: article
Study design: Case Report
Abstract: Nasopharyngeal carcinoma (NPC) has a strong association with Epstein-Barr virus (EBV) infection.We present the case of a 45-year-old male with non-keratinizing NPC cT1N2M0 and serum EBV DNA positivity (1.4 × 10 3 copies/mL) in April 2022.He underwent three cycles of cisplatin/gemcitabine until October 2022 and was submitted to chemoradiotherapy, obtaining a partial imaging response and undetectable EBV DNA.In April 2023, he presented with bone and lymph node metastases, with EBV DNA < 250 copies/mL.He underwent palliative chemotherapy with carboplatin/paclitaxel and, after six cycles of treatment, showed concomitant disease progression with an increase in EBV viral load.He began treatment with nivolumab but maintained an increase in EBV DNA, and after two cycles, disease progression was confirmed, and rechallenge with gemcitabine was proposed.He obtained a partial response and EBV DNA < 250 copies/mL.Thus, monitoring plasma EBV DNA can play a role in surveillance and in assessing the response to Nicole Conradie therapy.Keywords: Nasopharyngeal carcinoma.Epstein-Barr virus infections.Herpesvirus 4. Human.Early detection of cancer.Resumo O carcinoma da nasofaringe (CN) tem uma forte associação com a infeção pelo vírus Epstein-Barr (EBV).Apresentamos o caso de um homem de 45 anos com CN não queratinizante cT1N2M0 e positividade sérica do DNA de EBV (1.4x10³ cópias/ mL) em 04/2022.Realizou 3 ciclos de cisplatina/gemcitabina até 10/2022 e foi submetido a quimiorradioterapia, tendo obtido resposta imagiológica parcial e ADN do EBV indetetável.Em 04/2023 apresentou metastização óssea e ganglionar com DNA do EBV < 250 cópias/mL.Foi submetido a quimioterapia paliativa com carboplatina/paclitaxel e, após 6 ciclos do tratamento, apresentou progressão de doença concomitante com aumento da carga vírica do EBV Iniciou tratamento com Nivolumab mas manteve aumento do DNA do EBV e, após 2 ciclos, confirmou-se progressão da doença, tendo sido proposto rechallenge com gemcitabina.Obteve resposta parcial e DNA EBV < 250 cópias/mL.Assim, a monitorização do DNA EBV plasmático pode ter papel na vigilância e na avaliação de resposta à terapêutica do CN.
Source: Revista Portuguesa Oncologia
Authors: Ana R. Teixeira, Cláudia Agostinho, Marta Pina
Institution: IPO Porto
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4415121972
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