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Use of circulating tumour DNA in nasopharyngeal carcinoma to detect minimal residual disease
  1. Bipin Ghimire1,
  2. Emma Herrman1,
  3. Ujjwal Karki1 and
  4. Mohammad Muhsin Chisti2
  1. 1Internal Medicine, Beaumont Health, Royal Oak, Michigan, USA
  2. 2Hematology and Medical Oncology, Oakland University William Beaumont School of Medicine, Troy, Michigan, USA
  1. Correspondence to Dr Bipin Ghimire; bipin.ghimire{at}


Circulating tumour DNA (ctDNA) is defined as short DNA sequences shed by tumour cells into the systemic circulation. A promising use of ctDNA includes the detection of minimal residual disease (MRD) and is currently being studied in multiple types of solid tumours. Literature for the use of individualised ctDNA in nasopharyngeal carcinoma (NPC) is not available, although circulating Epstein-Barr virus DNA level is validated as a prognostic factor. We present a man in his 40s diagnosed with stage IV NPC who was started on chemotherapy with cis-platinum and gemcitabine. Serial monitoring of ctDNA completed to aid in detecting MRD after treatment demonstrated initial up-trending values correlating with subsequent imaging findings showing progression. Reinitiation of a different chemotherapy regimen significantly improved the ctDNA level, with corresponding imaging exhibiting a similar response. This case provides insight into the potential use of ctDNA in NPC and the benefit of serial ctDNA monitoring during treatment.

  • Head and neck cancer
  • Cancer intervention
  • Ear, nose and throat/otolaryngology

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  • Contributors BG, EH and UK contributed to writing and editing the manuscript. BG obtained consent from the patient. MMC was directly involved in patient care, and supervising and editing the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.