耳鼻咽喉科・頭頸部外科86巻10号

2014年09月発行

特集 咽頭癌・頸部食道癌の治療戦略Update

≪個別化治療の現在≫

EBVからみた上咽頭癌の個別化治療

著者： 室野重之¹ 吉崎智一¹

所属機関： ¹金沢大学医薬保健研究域医学系耳鼻咽喉科・頭頸部外科

ページ範囲：P.798 - P.806

文献概要

POINT

●EBVと上咽頭癌の関係について，発癌機構および高転移能は解明されてきたが，これまで臨床的な応用はなされていない。

●HPVと中咽頭癌の関係とは異なり，EBVの有無に基づく個別化治療への傾向はない。

●血漿中のEBV DNAは，上咽頭癌の診断だけでなく，病勢監視にも有用である。

●治療前および治療後の血漿中EBV DNAは予後と関連付けられる。後者がより強い相関を示す。

●治療後の血漿中EBV DNAに基づく補助化学療法の重要性に関する臨床試験が，好発地域で行われている。

参考文献

1）O'Sullivan B, et al：Deintensification candidate subgroups in human papillomavirus-related oropharyngeal cancer according to minimal risk of distant metastasis. J Clin Oncol 31：543-550, 2013

2）Baujat B, et al：Chemotherapy in locally advanced nasopharyngeal carcinoma：an individual patient data meta-analysis of eight randomized trial and 1753 patients. Int J Radiat Oncol Biol Phys 64：47-56, 2006

3）Al-Sarraf M, et al：Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer：phase Ⅲ randomized Intergroup study 0099. J Clin Oncol 16：1310-1317, 1998

4）Chen L, et al：Concurrent chemoradiotherapy plus adjuvant chemotherapy versus concurrent chemodariotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma：a phase 3 multicentre randomised controlled trial. Lancet Oncol 13：163-171, 2012

，およびその他のNCCNのコンテンツはNational Comprehensive Cancer Network, Inc.の登録商標である．

6）OuYang PY, et al：Significant efficacies of neoadjuvant and adjuvant chemotherapy for nasopharyngeal carcinoma by meta-analysis of published literature-based randomized, controlled trials. Ann Oncol 24：2136-2146, 2013

7）Hui EP, et al：Randomized phase Ⅱ trial of concurrent cisplatin-radiotherapy with or without neoadjuvant docetaxel and cisplatin in advanced nasoharyngeal carcinoma. J Clin Oncol 27：242-249, 2009

8）Zhang L, et al：Emerging treatment options for nasopharyngeal carcinoma. Drug Des Devel Ther 7：37-52, 2013

9）Wang WY, et al：Long-term survival analysis of nasopharyngeal carcinoma by plasma Epstein-Barr virus DNA levels. Cancer 119：963-970, 2013

10）Twu CW, et al：Comparison of the prognostic impact of serum anti-EBV antibody and plasma EBV DNA assays in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 67：130-137, 2007

11）Yip TTC, et al：Application of circulating plasma/serum EBV DNA in the clinical management of nasopharyngeal carcinoma. Oral Oncol 50：527-538, 2014

12）Chien YC, et al：Serologic marker of Epstein-Barr virus infection and nasopharyngeal carcinoma in Taiwanese men. N Engl J Med 345：1877-1882, 2001

13）Lee WY, et al：Epstein-Barr virus detection in neck metastases by in-situ hybridization in fine-needle aspiration cytologic studies：an aid for differentiating the primary site. Head Neck 22：336-340, 2000

14）Ke K, et al：Epstein-Barr virus-encoded RNAs as a survival predictor in nasopharyngeal carcinoma. Chin Med J（Engl）127：294-299, 2014

15）Lo YM, et al：Quantitative analysis of cell-free Epstein-Barr virus DNA in plasma of patients with nasopharyngeal carcinoma. Cancer Res 59：1188-1191, 1999

16）Li S, et al：Diagnostic value of Epstein-Barr virus capsid antigen-IgA in nasopharyngeal carcinoma：a meta-analysis. Chin Med J（Engl）123：1201-1205, 2010

17）Lo YM：Quantitative analysis of Epstein-Barr virus DNA in plasma and serum：applications to tumor detection and monitoring. Ann N Y Acad Sci 945：68-72, 2001

18）Chan AT, et al：Plasma Epstein-Barr virus DNA and residual disease after radiotherapy for undifferentiated nasopharyngeal carcinoma. J Natl Cancer Inst 94：1614-1619, 2002

19）Chan AT, et al：Phase Ⅱ study of neoadjuvant carboplatin and paclitaxel followed by radiotherapy and concurrent cisplatin in patients with locoregionally advanced nasopharyngeal carcinoma；therapeutic monitoring with plasma Epstein-Barr virus DNA. J Clin Oncol 22：3053-3060, 2004

20）Leung SF, et al：Plasma Epstein-Barr viral DNA load at midpoint of radiotherapy course predicts outcome in advanced-stage nasopharyngeal carcinoma. Ann Oncol 25：1204-1208, 2014

21）Chan KC, et al：Circulating EBV DNA as a tumor marker for nasopharyngeal carcinoma. Semin Cancer Biol 12：489-496, 2002

22）Raghupathy R, et al：Epstein-Barr virus as a paradigm in nasopharyngeal cancer：from lab to clinic. Am Soc Clin Oncol Educ Book：149-153, 2014

23）Chan ATC, et al：A multicenter randomized controlled trial of adjuvant chemotherapy in nasopharyngeal carcinoma with residual plasma EBV DNA following primary radiotherapy or chemoradiotherapy［abstract］. J Clin Oncol 30（suppl）：Abstract 5511, 2012

24）Le QT, et al：An international collaboration to harmonize the quantitative plasma Epstein-Barr virus DNA assay for future biomarker-guided trials in nasopharyngeal carcinoma. Clin Cancer Res 19：2208-2215, 2013

25）Leung SF, et al：Plasma Epstein-Barr viral deoxyribonucleic acid quantitation complements tumor-node-metastasis staging prognostication in nasopharyngeal carcinoma. J Clin Oncol 24：5414-5418, 2006

26）Yoshizaki T, et al：Pathogenic role of Epstein-Barr virus latent membrane protein-1 in the development of nasopharyngeal carcinoma. Cancer Lett 337：1-7, 2013

27）Tsang J, et al：Novel therapy for nasopharyngeal carcinoma—Where are we. Oral Oncol：Epub ahead of print