Relevance of tumor markers for prognosis and predicting therapy response in non-small cell lung cancer patients: A...

Area of Science:

• Oncology
• Biomarker Research
• Clinical Trials

Background:

• Advanced non-small cell lung cancer (NSCLC) is associated with elevated protein tumor markers in the blood.
• The clinical utility of serum tumor markers (STM) in NSCLC requires further investigation.

Purpose of the Study:

• To evaluate the prognostic and predictive value of various serum tumor markers (STM) in patients with advanced non-small cell lung cancer (NSCLC) undergoing chemotherapy.
• To assess the role of STM in monitoring therapy response.

Main Methods:

• A biomarker substudy of the prospective, multicentric CEPAC-TDM clinical trial involving 261 advanced NSCLC patients.
• Serial serum samples were analyzed for CYFRA 21-1, CEA, SCC, NSE, ProGRP, CA125, CA15-3, and HE4.
• Correlations were made between STM levels, radiological response, overall survival (OS), and progression-free survival (PFS).

Main Results:

• While initial STM levels did not differentiate progressive from non-progressive disease, CYFRA 21-1, CA125, NSE, and SCC at staging were predictive (AUCs 0.67-0.75).
• High pretherapeutic levels of CA15-3 and CA125, and elevated CYFRA 21-1, SCC, CA125, and CA15-3 at staging were prognostic for shorter PFS and OS.
• These prognostic associations remained significant even after including clinical variables.

Conclusions:

• Serum tumor markers (STM) assessed at the time of first radiological staging are predictive of first-line treatment response in advanced NSCLC.
• Pretherapeutic CA15-3 and CA125 levels, along with STM at staging, are highly prognostic for survival in advanced NSCLC patients.