Value of Serum Markers in Evaluating the Curative Effect of Immune Checkpoint Inhibitors for Lung Cancer
Background:
In recent years, immune checkpoint inhibitors (ICIs) have been widely used in the treatment of lung cancer, and they significantly improve the survival rate of patients. However, the benefit rate of ICIs immunotherapy for lung cancer patients is only 15 - 40%. It is necessary to find effective and reliable biomarkers for evaluating the curative effect to achieve accurate immunotherapy for lung cancer. Therefore, the objective of this study was to analyze the value of response evaluation through detecting serum neuron-specific enolase (NSE), pro-gastrin-releasing peptide (pro-GRP), cytokeratin 19 fragment (Cyfra21-1), squamous cell carcinoma antigen (SCC), and carcinoembryonic antigen (CEA) in the lung cancer patients treated with ICIs.
Methods:
The levels of serum NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the lung cancer patients of pre- and post-immunotherapy with ICIs were detected by flow fluorescence method.
Results:
The serum levels of NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the patients with partial remission were decreased after ICIs immunotherapy of 2 cycles, and the difference was statistically significant (p < 0.05). The serum levels of Cyfra21-1, CEA, and SCC in the patients with stable disease were significantly decreased (p < 0.05). The serum levels of NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the patients with disease progression were signi-ficantly increased (p < 0.05). The percentages of positive NSE or pro-GRP in the SCLC patients before treatment were significantly higher than these of NSCLC patients (p < 0.001). The percentages of positive Cyfra21-1 or SCC in the NSCLC patients before treatment were significantly higher than these of SCLC patients (p < 0.001). There was no significant difference between positive CEA in the NSCLC and SCLC patients before treatment (p > 0.05). The sensitivities of NSE, pro-GRP, Cyfra21-1, SCC, and CEA in evaluating the efficacy of immunotherapy were 92.3%, 84.6%, 95.4%, 96.7%, and 81.3%.
Conclusions:
The changed levels of serum NSE, pro-GRP, Cyfra21-1, SCC, and CEA in the lung cancer patients in pre- and post-immunotherapy with ICIs were related to the therapeutic effect and may be used for the response evaluation. The SCLC patients should choose serum NSE, pro-GRP, and CEA for the response evaluation of ICIs immunotherapy, and the NSCLC patients should choose serum Cyfra21-1, SCC, and CEA.
