Prognostic role of serum cytokeratin 19 fragments in advanced non-small-cell lung cancer: association of marker changes after two chemotherapy cycles with different measures of clinical response and survival

• Published in: British journal of cancer Vol. 98; no. 1; pp. 77 - 79
• Main Authors: Nisman, B, Biran, H, Heching, N, Barak, V, Ramu, N, Nemirovsky, I, Peretz, T
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 15-01-2008; Nature Publishing Group
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adult; Aged; Antigens, Neoplasm - blood; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomarkers, Tumor - blood; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cancer therapies; Carcinoma, Large Cell - blood; Carcinoma, Large Cell - drug therapy; Carcinoma, Large Cell - mortality; Carcinoma, Non-Small-Cell Lung - blood; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Squamous Cell - blood; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Chemotherapy; Clinical Study; Cytokeratin; Drug Resistance; Epidemiology; Female; Humans; Keratin-19; Keratins - blood; Lung cancer; Lung diseases; Lung Neoplasms - blood; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Male; Medical research; Medical sciences; Middle Aged; Molecular Medicine; Neoplasm Staging; Oncology; Patients; Pneumology; Prognosis; Prospective Studies; Survival analysis; Survival Rate; Treatment Outcome; Tumors; Tumors of the respiratory system and mediastinum; Israel; clinical response; non-small-cell lung carcinoma; survival prediction; CYFRA 21-1; Lung disease; Prognosis; Respiratory disease; Lung cancer; Biological marker; Cytokeratin 19; Tumoral marker; Malignant tumor; non-small cell lung carcinoma; Survival; Cycle; Fragmentation; Chemotherapy; Treatment; Cancerology; Bronchus disease; Advanced stage; Serum; Predictive factor; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6604157

Prognostic implication of serum cytokeratin 19 fragments (CYFRA 21-1) was explored in 60 advanced NSCLC patients, whereas in 45 patients assessable for serological response a ⩾35% CYFRA 21-1 decline after two chemotherapy cycles was strongly associated with non-progression (NP), defined as a sum of objective response (OR)+stable disease (
P
<0.0001) and survival (
P
=0.0002). Association of OR with survival was not significant. In multivariate survival analysis, ⩾35% marker decline and radiological NP status were found as major determinants of prolonged survival with RR: 0.37 (
P
=0.01) and 0.63 (
P
=0.01), respectively. In advanced NSCLC patients, NP reflects therapeutic efficacy better than traditional OR. CYFRA 21-1 ⩾35% decline seems to be a reliable surrogate marker of treatment efficacy in terms of survival.