Decline in serum carcinoembryonic antigen and cytokeratin 19 fragment during chemotherapy predicts objective response and survival in patients with advanced nonsmall cell lung cancer
Open Access
- 8 December 2006
- Vol. 107 (12) , 2842-2849
- https://doi.org/10.1002/cncr.22330
Abstract
BACKGROUND. The authors assessed the predictive and prognostic role of decline in the serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21‐1) during chemotherapy in patients with advanced nonsmall cell lung cancer (NSCLC). METHODS. Changes in serum levels of CEA and CYFRA 21‐1 during first‐line, conventional chemotherapy were studied prospectively with an immunometric assay at baseline and every 2 courses in 117 patients with advanced NSCLC. Data were correlated with radiologic objective response (OR) and survival. RESULTS. One hundred seven patients were evaluable for radiologic and serologic response assessment after 2 chemotherapy courses. The radiologic OR rate was 44% overall. The CEA and CYFRA 21‐1 responses (≥20% reduction over baseline level; assessed after the second course of chemotherapy) were 38% and 61%, respectively. Statistically significant correlations were observed between CEA and CYFRA 21‐1 responses and OR (P = .01 and P = .004, respectively). The median survival from response assessment (landmark analysis) was 9 months. In a univariate analysis, disease stage, performance status, baseline lactate dehydrogenase level (LDH), OR, CEA response, and CYFRA 21‐1 response were correlated significantly with survival. In particular, the median survival was 13 months for patients who had a CEA response and 11 months for patients who had a CYFRA 21‐1 response compared with 8 months and 6 months for patients who did not respond, respectively. In a multivariate analysis, performance status (P = .005), baseline LDH level (P = .02), CEA response (P = .03) and CYFRA 21‐1 response (P = .01) were confirmed as independent prognostic factors for survival. CONCLUSIONS. CEA and CYFRA 21‐1 responses appeared to be reliable surrogate markers of chemotherapy efficacy in patients with advanced NSCLC. Cancer 2006. © 2006 American Cancer Society.Keywords
This publication has 17 references indexed in Scilit:
- [18F]Fluorodeoxyglucose Uptake by Positron Emission Tomography Predicts Outcome of Non–Small-Cell Lung CancerJournal of Clinical Oncology, 2005
- Circulating Nucleosomes Predict the Response to Chemotherapy in Patients with Advanced Non–Small Cell Lung CancerClinical Cancer Research, 2004
- CYFRA 21-1 is a prognostic determinant in non-small-cell lung cancer: results of a meta-analysis in 2063 patientsBritish Journal of Cancer, 2004
- Prognostic value of combination of Cyfra 21-1, CEA and NSE in patients with advanced non-small cell lung cancerRespiratory Medicine, 2004
- American Society of Clinical Oncology Treatment of Unresectable Non–Small-Cell Lung Cancer Guideline: Update 2003Journal of Clinical Oncology, 2004
- Positron Emission Tomography in Non–Small-Cell Lung Cancer: Prediction of Response to Chemotherapy by Quantitative Assessment of Glucose UseJournal of Clinical Oncology, 2003
- Tumor Markers (CEA, CA 125, CYFRA 21-1, SCC and NSE) in Patients with Non-Small Cell Lung Cancer as an Aid in Histological Diagnosis and PrognosisTumor Biology, 2003
- Phase III Trial Comparing a Defined Duration of Therapy Versus Continuous Therapy Followed by Second-Line Therapy in Advanced-Stage IIIB/IV Non-Small-Cell Lung CancerJournal of Clinical Oncology, 2002
- Usefulness of longitudinal evaluation of Cyfra 21-1 variations in advanced lung cancer monitoringLung Cancer, 1997
- The meaning and use of the area under a receiver operating characteristic (ROC) curve.Radiology, 1982