Malignancies associated with epstein-barr virus: pathobiology, clinical features, and evolving treatments

Epstein-Barr virus (EBV) is associated with a wide variety of B-cell-derived lymphoid neoplasms, including Burkitt lymphoma, lymphomas arising in immunocompromised patients (post-transplant and HIV-associated lymphomas), and Hodgkin lymphoma. In addition, EBV has been linked to some T-cell lymphomas (angioimmunoblastic T-cell lymphoma, extranodal nasal-type natural killer/T-cell lymphoma, and other rare histotypes), nasopharyngeal cancer, and a subset of gastric cancers. Advances in our understanding of the pathobiology of EBV oncogenesis, including the transforming and immunogenic properties of the virus and the role of immune dysregulation, have provided the rationale for new treatment strategies. Emerging EBV-specific therapeutic approaches include activation of lytic viral infection combined with antiviral drugs, inhibition of EBV-induced oncogenic cellular signaling pathways, adoptive EBV-specific T-cell therapies, and EBV vaccines. This review summarizes the pathobiology, clinical features, and treatment of EBV-associated malignancies, including new and evolving therapies focused on exploiting the pathobiology of EBV.