J.W. Ankersmid , C.H.C. Drossaert , L.J.A. Strobbe , M.Q.N. Hackert , N. Engels , J.C.M. Prick , S. Teerenstra , Y.E.A. van Riet , R. The , C.F. van Uden-Kraan , S. Siesling , on behalf of the Santeon VBHC Breast Cancer Group
{"title":"Shared decision-making supported by outcome information regarding surveillance after curative treatment for breast cancer: Results of the SHOUT-BC study","authors":"J.W. Ankersmid , C.H.C. Drossaert , L.J.A. Strobbe , M.Q.N. Hackert , N. Engels , J.C.M. Prick , S. Teerenstra , Y.E.A. van Riet , R. The , C.F. van Uden-Kraan , S. Siesling , on behalf of the Santeon VBHC Breast Cancer Group","doi":"10.1016/j.ejca.2024.115107","DOIUrl":"10.1016/j.ejca.2024.115107","url":null,"abstract":"<div><h3>Background</h3><div>Integrating outcome information into the process of shared decision-making (SDM) about post-treatment surveillance can enhance its effectiveness. The Breast Cancer Surveillance Decision Aid (BCS-PtDA) integrates risk estimations of patients’ risks for recurrences as well as outcome information on fear of cancer recurrence (FCR). The SHOUT-BC study aimed to evaluate the effectiveness of the implementation of the BCS-PtDA. Patients’ satisfaction with the BCS-PtDA was also evaluated.</div></div><div><h3>Methods</h3><div>As described in a previously published protocol paper, the study employed a Prospective multiple interrupted time series (ITS) design in which the BCS-PtDA was implemented stepwise into the care pathways of eight Dutch hospitals.</div></div><div><h3>Results</h3><div>A total of 507 participants completed a questionnaire after their first surveillance consultation which usually takes place approximately one year after surgery. ITS analysis per hospital and subsequent meta-analysis over hospital effects indicated a significant increase in patient-reported SDM from pre- to post-implementation (overall estimated effect: 27.14, 95 % CI: 22.71 to 31.87, <em>p</em> < .0001). Moreover, post-implementation participants (<em>n</em> = 225) reported a more active role in decision-making, decreased decisional conflict, and increased knowledge on the aim and methods of surveillance. Furthermore, a decrease in FCR was seen post-implementation. The self-reported intensity of surveillance schedules decreased slightly and the BCS-PtDA received highly positive evaluations.</div></div><div><h3>Discussion</h3><div>The implementation of the BCS-PtDA, which integrates outcome information, led to increased patient-reported SDM and an improved quality of decision-making. The BCS-PtDA was evaluated highly positively by participants. Further research should address optimisation of the implementation.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lingyun Sun , Yun Xu , Nan Chen , Chunze Zhang , Aiwen Wu , Huaqing Wang , Yutong Fei , Peng Shu , Dechang Diao , Jianping Cheng , Yuping Chu , Tianshu Liu , Wei Wang , Ye Yuan , Baozhu Zeng , Yang Cao , Shundong Cang , Huijuan Cao , Tong Zhang , Yang Zheng , Yufei Yang
{"title":"Chinese herbal medicine (JianPi-BuShen) and completion rate of adjuvant chemotherapy for patients with stage II and III colon cancer: A randomized clinical trial","authors":"Lingyun Sun , Yun Xu , Nan Chen , Chunze Zhang , Aiwen Wu , Huaqing Wang , Yutong Fei , Peng Shu , Dechang Diao , Jianping Cheng , Yuping Chu , Tianshu Liu , Wei Wang , Ye Yuan , Baozhu Zeng , Yang Cao , Shundong Cang , Huijuan Cao , Tong Zhang , Yang Zheng , Yufei Yang","doi":"10.1016/j.ejca.2024.115109","DOIUrl":"10.1016/j.ejca.2024.115109","url":null,"abstract":"<div><h3>Purpose</h3><div>Many cancer patients express interest in using herbal medicine during chemotherapy, but little is known about its benefits and risks. This study aimed to evaluate the effects of the Chinese herbal medicine JianPi-BuShen formula (JPBS) on adjuvant chemotherapy completion in colon cancer patients.</div></div><div><h3>Patients and methods</h3><div>This multi-center, phase III, randomized, placebo-controlled trial included patients with stage II (high risk for recurrence) and stage III colon cancer following surgery, planning to receive CAPOX (capecitabine and oxaliplatin) chemotherapy. Patients were randomized 1:1 to receive either JPBS or a placebo. The primary outcome was the completion rate of planned chemotherapy cycles. Secondary outcomes included relative dose intensity (RDI), chemotherapy-induced toxicities, quality of life (measured by the Edmonton Symptom Assessment System - ESAS), adverse events (AEs), and serious AEs (SAEs). Predefined subgroup analyses were performed by age (>65/≤65) and TNM stage (II/III).</div></div><div><h3>Results</h3><div>A total of 376 participants were analyzed, with a median age of 60.3 years; 56.9 % were male, and 67.6 % had stage III disease. Chemotherapy completion was significantly higher in the JPBS group than in the placebo group (63.0 % vs. 47.6 %, P = 0.003). Oxaliplatin RDI was also higher in the JPBS group (P = 0.049). Subgroup analyses showed JPBS significantly improved completion rates for stage II patients (73.0 % vs. 42.4 %, P = 0.001) and younger patients (66.9 % vs. 48.8 %, P = 0.004). JPBS reduced grade ≥ 2 vomiting (3.8 % vs. 6.4 %, P = 0.007) but increased grade ≥ 2 thrombocytopenia (16.2 % vs. 12.4 %, P = 0.012). Quality of life improved in stage II and younger patients.</div></div><div><h3>Conclusion</h3><div>JPBS improved chemotherapy completion rates in stage II and younger colon cancer patients without compromising tolerability. Further research is needed to explore its mechanisms and long-term effects.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annie Xiao , Xiaochen Li , Chongkai Wang , Jian Ye , Marwan Fakih
{"title":"Updated survival outcome of regorafenib, ipilimumab, and nivolumab in refractory microsatellite stable non-liver metastatic colorectal cancer: A phase I nonrandomized clinical trial","authors":"Annie Xiao , Xiaochen Li , Chongkai Wang , Jian Ye , Marwan Fakih","doi":"10.1016/j.ejca.2024.115111","DOIUrl":"10.1016/j.ejca.2024.115111","url":null,"abstract":"<div><h3>Background</h3><div>Combination regorafenib, ipilimumab, and nivolumab (RIN) was evaluated in a phase 1 nonrandomized study (NCT04362839) of refractory microsatellite stable (MSS) metastatic colorectal cancer. Promising antitumor activity was previously reported in the non-liver metastatic (NLM) population. This updated analysis describes long-term survival outcomes in the NLM cohort and highlights durable remissions with potential cure following completion of RIN therapy.</div></div><div><h3>Methods</h3><div>Between May 2020 and January 2022, 39 patients with refractory MSS metastatic colorectal cancer were enrolled. Patients received RIN until progression, unacceptable toxicity, or completion at two years. The primary endpoint was recommended phase 2 dose (RP2D) selection. Secondary endpoints were safety, overall response rate (ORR), progression-free survival (PFS) and overall survival (OS) at the RP2D level.</div></div><div><h3>Results</h3><div>22 patients with refractory non-liver metastatic MSS colorectal cancer were treated at the RP2D of RIN. ORR was 36.4 % (8/22 patients), and median PFS was 5.0 months (95 % CI: 3–9). After a median follow-up of 42 months, the 1-, 2-, and 3-year PFS rates were 24.1 %, 24.1 %, and 19.3 % by RECIST. The median OS was 27.5 months (95 % CI: 14.0 to NE). At data cutoff, 6 patients had ongoing clinical benefit, including 3 responders who remain disease-free > 18 months after treatment completion.</div></div><div><h3>Conclusion</h3><div>With extended follow-up, RIN combination therapy demonstrated durable clinical benefit in a subset of patients with NLM MSS metastatic colorectal cancer, including potential cure in 3 responders who remain disease-free > 18 months after treatment completion.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142587306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hein V. Stroomberg , J. Thomas Helgstrand , Klaus Brasso , Signe Benzon Larsen , Andreas Røder
{"title":"Epidemiology of men with synchronous metastatic prostate cancer diagnosis – A nationwide 26-year temporal analysis","authors":"Hein V. Stroomberg , J. Thomas Helgstrand , Klaus Brasso , Signe Benzon Larsen , Andreas Røder","doi":"10.1016/j.ejca.2024.115110","DOIUrl":"10.1016/j.ejca.2024.115110","url":null,"abstract":"<div><h3>Background</h3><div>Evolving imaging modalities, increased awareness, and prostate-specific antigen testing in men with synchronous metastatic prostate cancer (mHSPC) are expected to have prolonged survival. Here we analyze trends in survival among men diagnosed with synchronous metastatic prostate cancer in Denmark.</div></div><div><h3>Methods</h3><div>Here, we included all men diagnosed with mHSPC (N = 12,017) in Denmark between January 1st, 1995, and December 31st, 2021. Men were followed until December 31st, 2022. Median time to death was calculated by the Kaplan Meier method and the 3-year risk of prostate cancer death per calendar year was estimated by the Aalen-Johansen estimator from time of diagnosis.</div></div><div><h3>Findings</h3><div>Median follow-up was 9 years (IQR: 4–15), from 2015 59 % of the men with mHSPC had treatment beyond androgen depletion therapy. Median survival increased from 1.7 years (IQR: 1·3–2·0) to 3.8 years (IQR: 3·3–4·2) in men diagnosed in 1995 and 2018, respectively (p < 0·001), after which median survival was not reached. The prostate cancer-specific mortality three years after diagnosis decreased from 66 % (95 %CI: 60–72) in 1995 to 28 % (95 %CI: 25–32) in 2019 (p < 0·001). From the period 1995–1999 to 2015–2021 median overall survival increased from 1·7 years (IQR: 0·8–3·7) to 4·5 years (IQR: 2·4-not reached; p < 0·001) in men age < 65 years and from 1·5 years (IQR: 0·7–2·9) to 3·1 years (IQR: 1·6–5·7; p < 0.001) in men older than 74 years at diagnosis.</div></div><div><h3>Interpretation</h3><div>The improved survival suggests that, among other contributing factors, implementing novel therapies has likely been efficacious outside the clinical trial setting. Still, most men diagnosed with synchronous metastatic prostate cancer will die of prostate cancer. As such the need for life-prolonging and age-tailored treatment trials remains evident.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to “Letter re: High serum sodium predicts immunotherapy response in metastatic renal cell and urothelial carcinoma” [Eur J Cancer, 207, August 2024, 114173]","authors":"Hujian Hong , Yanli Qu","doi":"10.1016/j.ejca.2024.115101","DOIUrl":"10.1016/j.ejca.2024.115101","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Claudio Sini, Alessandro Di Federico, Paolo Bironzo, Andrea De Giglio, Francesco Gelsomino
{"title":"Letter Re: Indirect comparison of capmatinib treatment from GEOMETRY mono-1 trial to SOC in German patients with locally advanced or metastatic NSCLC harboring METex14 skipping mutations.","authors":"Claudio Sini, Alessandro Di Federico, Paolo Bironzo, Andrea De Giglio, Francesco Gelsomino","doi":"10.1016/j.ejca.2024.115085","DOIUrl":"https://doi.org/10.1016/j.ejca.2024.115085","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carmine Valenza , Dario Trapani , Paola Zagami , Gabriele Antonarelli , Luca Boscolo Bielo , Eleonora Nicolò , Joana Mourato Ribeiro , Lorenzo Guidi , Carolina Reduzzi , Martina Spotti , Laura Adamoli , Javier Cortès , Barbara Pistilli , Sara M. Tolaney , Naoto Ueno , Rachel M. Layman , Massimo Cristofanilli , Lisa A. Carey , Elisabetta Munzone , Carmen Criscitiello , Giuseppe Curigliano
{"title":"Immune checkpoint inhibitors for patients with metastatic triple-negative inflammatory breast cancer (INCORPORATE): An international cohort study","authors":"Carmine Valenza , Dario Trapani , Paola Zagami , Gabriele Antonarelli , Luca Boscolo Bielo , Eleonora Nicolò , Joana Mourato Ribeiro , Lorenzo Guidi , Carolina Reduzzi , Martina Spotti , Laura Adamoli , Javier Cortès , Barbara Pistilli , Sara M. Tolaney , Naoto Ueno , Rachel M. Layman , Massimo Cristofanilli , Lisa A. Carey , Elisabetta Munzone , Carmen Criscitiello , Giuseppe Curigliano","doi":"10.1016/j.ejca.2024.115097","DOIUrl":"10.1016/j.ejca.2024.115097","url":null,"abstract":"<div><h3>Background</h3><div>Inflammatory breast cancer (IBC) is the most aggressive clinical presentation of breast cancer, recapitulating a specific biology with more immune-vulnerability than non-IBC. Patients with metastatic, triple-negative IBC (mTN-IBC) receive immune checkpoint inhibitors (ICIs) and chemotherapy, similarly to patients with triple-negative non-IBC. However, the benefit derived from ICI incorporation in this rare type of breast cancer is unknown.</div></div><div><h3>Methods</h3><div>We conducted a multicenter, international, retrospective, cohort study to evaluate the activity of ICIs in patients with metastatic, triple-negative, primary IBC, who received ICIs plus first line chemotherapy from January 2015 to April 2023. A sample size of 42 patients allowed to detect an increase in 6-months real-world progression-free survival (rwPFS) rate from 40 % with only chemotherapy to 60 % with ICI and chemotherapy.</div></div><div><h3>Results</h3><div>41 patients from eight international IBC referral centers were included (61 % with primary, <em>de novo</em> mTN-IBC, 61 % with visceral disease). All received ICIs plus first line chemotherapy and 24 % underwent breast surgery and/or locoregional radiotherapy. After a median follow-up of 19.3 months, the 6-months rwPFS rate was 30 % (95 % Confidence Interval [CI], 17–45 %), the median rwPFS was 3.3 months (95 % CI: 2.2–5.4), the median overall survival was 15.7 months (95 % CI: 6.8–16.3).</div></div><div><h3>Conclusions</h3><div>This one-sample analysis showed a poor outcome of patients with mTN-IBC, despite the treatment with ICI, in contrast with the expected benefit based on preclinical evidence of immune-vulnerability of IBC. These results suggest the need to further investigate the role of immunotherapy in this aggressive and rare type of breast cancer presentation.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne-Sophie Fisch , Ana Pestana , Vanessa Sachse , Christian Doll , Elena Hofmann , Max Heiland , Theresa Obermueller , Jan Heidemann , Steffen Dommerich , Diana Schoppe , Simon Schallenberg , Iris Piwonski , Eric Blanc , Ingeborg Tinhofer
{"title":"Feasibility analysis of using patient-derived tumour organoids for treatment decision guidance in locally advanced head and neck squamous cell carcinoma","authors":"Anne-Sophie Fisch , Ana Pestana , Vanessa Sachse , Christian Doll , Elena Hofmann , Max Heiland , Theresa Obermueller , Jan Heidemann , Steffen Dommerich , Diana Schoppe , Simon Schallenberg , Iris Piwonski , Eric Blanc , Ingeborg Tinhofer","doi":"10.1016/j.ejca.2024.115100","DOIUrl":"10.1016/j.ejca.2024.115100","url":null,"abstract":"<div><h3>Background</h3><div>Current treatment for head and neck squamous cell carcinoma (HNSCC) involves surgery, radiotherapy, and chemotherapy. Despite aggressive multimodal approaches, tumour recurrence occurs in 40–60 % of cases, leading to poor survival outcomes. HNSCC lacks common genetic drivers for tailored therapies, and reliable biomarkers for treatment selection are scarce. We investigated the procedural requirements for incorporating drug- and radiosensitivity screens in patient-derived organoids (PDOs) within a clinical trial framework.</div></div><div><h3>Patients and methods</h3><div>Fresh tumour samples (<em>N</em> = 198) from 186 HNSCC patients were included. Success rates of organoid establishment were correlated with clinical and procedural parameters. Timelines for establishment of PDO cultures were determined, and their long-term growth potential assessed by serial passaging. Additionally, we conducted whole exome sequencing on matched tumour-organoid pairs. Three PDO models were employed to establish radiosensitivity assays.</div></div><div><h3>Results</h3><div>In total, PDO models displaying histomorphological features and genomic alterations of parental tumours were successfully established for 35 % of patient tumours. Success rates rose to 77 % for samples with a tumour cell content of 30 % or higher. Advanced patient age, prior radiotherapy, and delays in tissue processing were identified as negative predictors for engraftment. The estimated time interval needed for screens was compatible with PDO-guided selection of curative-intent radiotherapy regimens.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that with high-quality samples and efficient tissue processing, PDO screens can be successfully performed in 77 % of HNSCC patients. Given the procedural challenges involved, future clinical trials aiming to the utility of PDOs for guiding treatment decisions should consider implementing centralised PDO screening.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qixian Zhang , Lin Zhu , Wenjiao Lv , Tingting Xu , Chunying Shen , Wei Qian , Peiyao Liu , Hongmei Ying , Xiayun He , Chaosu Hu , Xin Zhou , Xueguan Lu
{"title":"Liquid biopsy with plasma Epstein-Barr virus DNA characterizes biological relapse for the prediction of cancer recurrence in non-disseminated nasopharyngeal carcinoma","authors":"Qixian Zhang , Lin Zhu , Wenjiao Lv , Tingting Xu , Chunying Shen , Wei Qian , Peiyao Liu , Hongmei Ying , Xiayun He , Chaosu Hu , Xin Zhou , Xueguan Lu","doi":"10.1016/j.ejca.2024.115098","DOIUrl":"10.1016/j.ejca.2024.115098","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether a bounce in plasma Epstein-Barr virus (EBV) DNA during posttreatment surveillance of nasopharyngeal carcinoma (NPC) informs the risk of clinical recurrence and its implication for early therapeutic intervention.</div></div><div><h3>Methods</h3><div>950 non-disseminated NPC patients with completed remission in 3 months after treatment were retrospectively screened. Detectable EBV DNA with no evidence of clinical relapse during follow-up was deemed as DNA bounce. The diagnostic and prognostic performance of EBV DNA bounce was assessed for subsequent failures.</div></div><div><h3>Results</h3><div>Tumor recurrence occurred in 6.6 %, 10.1 % and 65.8 % in the group with persistently negative EBV DNA, single positive test and ≥ 2 positive tests, respectively. EBV DNA bounce over twice was associated with worse disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), and distant metastasis-free survival (DMFS) than the other two groups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for the prediction of recurrence were 0.56, 0.95, 0.66, 0.93 and 0.90 using two positive tests, which were hence deemed as biological relapse. Serial cutoffs (EBV DNA 1 ≥ 40 copies/ml or EBV DNA 2 ≥100 copies/ml) further defined a high-risk subgroup with an eventual recurrence rate of 77.9 % and 3-year DFS of merely 20.5 %. Prophylactic medical intervention with capecitabine or S1 significantly improved the 3-year DFS when compared to those with observation.</div></div><div><h3>Conclusions</h3><div>The earliest two positive tests of EBV DNA represent a biomarker of biological relapse that allows early detection of clinical recurrence in EBV-related NPC. For high-risk biological relapse, preemptive intervention provides potential survival benefits.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}