ArticleInfectious agents and cancer2025
Influence of blood EBV-DNA level on survival of patients with nasopharyngeal cancer on immune checkpoint inhibitors: a meta-analysis.
Article in Infectious agents and cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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3 authors.
Funding
Abstract
objectivesPretreatment plasma Epstein–Barr virus (EBV) DNA is a promising biomarker in nasopharyngeal cancer (NPC). However, its prognostic significance in patients receiving immune checkpoint inhibitors (ICIs) remains unclear. This meta-analysis evaluated the association between pretreatment EBV-DNA levels and survival outcomes in NPC patients treated with ICIs.
methodsPubMed, Embase, and Web of Science were searched up to June 29, 2025. Eligible longitudinal studies included adult NPC patients treated with ICIs, with pretreatment EBV-DNA assessed by quantitative PCR and survival outcomes reported as hazard ratios (HRs). Pooled analyses used random-effects models accounting for the potential influence of heterogeneity.
resultsThirteen cohorts from 12 studies, comprising 1,507 patients, were included. Most cohorts were prospective; two were retrospective. Overall, high pretreatment EBV-DNA was significantly associated with poorer progression-free survival (PFS; HR = 1.72, 95% CI: 1.46 to 2.03, p < 0.001; I² = 0%) and overall survival (OS; HR = 2.03, 95% CI: 1.50 to 2.77, p < 0.001; I² = 18%). Sensitivity analyses by excluding one study at a time showed similar results. Subgroup analyses for the outcome of PFS showed consistent associations across study design (prospective vs. retrospective), treatment line (first vs. later), concurrent therapy, cutoff thresholds (< 7,800 vs. ≥ 7,800 copies/mL), follow-up duration, analytic model, and study quality (all p for subgroup differences > 0.05).
conclusionsHigh pretreatment EBV-DNA levels predict significantly worse PFS and OS in NPC patients receiving ICIs. Pretreatment EBV-DNA may serve as a practical biomarker for risk stratification and treatment decision-making in this population. CLINICAL TRIAL NUMBER: Not applicable.
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