Prognostic and Predictive Value of Carcinoembryonic Antigen and Cytokeratin-19 Fragments Levels in Advanced Non-Small Cell Lung Cancer Patients Treated with Gefitinib or Erlotinib.
10.3349/ymj.2012.53.5.931
- Author:
Minkyu JUNG
1
;
Se Hyun KIM
;
Soojung HONG
;
Young Ae KANG
;
Se Kyu KIM
;
Joon CHANG
;
Sun Young RHA
;
Joo Hang KIM
;
Dae Joon KIM
;
Byoung Chul CHO
Author Information
1. Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea. cbc1971@yuhs.ac
- Publication Type:Retracted Publication ; Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Carcinoma;
non-small-cell lung;
biological markers;
carcinoembryonic antigen;
CYFRA 21-1;
tyrosine kinase inhibitor
- MeSH:
Adenocarcinoma;
Biomarkers;
Carcinoembryonic Antigen*;
Carcinoma, Non-Small-Cell Lung*;
Carcinoma, Squamous Cell;
Disease-Free Survival;
Erlotinib Hydrochloride*;
Female;
Humans;
Keratin-19*;
Prognosis;
Receptor, Epidermal Growth Factor
- From:Yonsei Medical Journal
2012;53(5):931-939
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The prognostic and predictive value of pretreatment serum levels of carcinoembryonic antigen (CEA) and cytokeratin-19 fragments (CYFRA 21-1) were assessed in advanced non-small cell lung cancer (NSCLC) patients treated with gefitinib or erlotinib. MATERIALS AND METHODS: Pretreatment CEA and CYFRA 21-1 were measured in 123 advanced NSCLC patients receiving gefitinib or erlotinib. High CEA levels (h-CEA) were significantly associated with females, patients with adenocarcinoma, and non-smokers. RESULTS: Low CYFRA 21-1 levels (l-CYFRA) were significantly associated with a good performance status (ECOG PS 0-1). The overall response rate (RR) was 27.6%, and higher RR was associated with adenocarcinoma, h-CEA, and epidermal growth factor receptor (EGFR) mutation. Patients with h-CEA had significantly longer progression-free survival (PFS) (p=0.021). Patients with l-CYFRA had significantly longer PFS and overall survival (p=0.006 and p<0.001, respectively). Of note, h-CEA and l-CYFRA had good prognosis in patients with unknown EGFR mutation status or patients with squamous cell carcinoma (p=0.021 and p=0.015, respectively). A good ECOG PS (HR=0.45, p=0.017), h-CEA (HR=0.41, p=0.007), l-CYFRA 21-1 (HR=0.52, p=0.025), and an EGFR mutation (HR=0.22, p<0.001) were independently predictive of a longer PFS. CONCLUSION: h-CEA and l-CYFRA 21-1 may be prognostic and predictive serum markers for higher response and longer survival in patients with advanced NSCLC receiving gefitinib or erlotinib, especially in patients with unknown EGFR mutation status or patients with squamous cell carcinoma.
