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Prognostic and predictive value of CEA and CYFRA 21-1 levels in advanced non-small cell lung cancer patients treated with gefitinib or erlotinib.

Abstract：

:The prognostic and predictive value of pre-treatment 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. Pre-treatment CEA and CYFRA 21-1 levels 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. Low CYFRA 21-1 levels (l-CYFRA 21-1) were significantly associated with a good performance status (ECOG PS 0-1). The overall response rate (RR) was 27.6%, and a 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 21-1 had significantly longer PFS and overall survival (OS) (P=0.006 and P<0.001, respectively). Notably, h-CEA and l-CYFRA 21-1 levels were associated with good prognosis in patients with unknown EGFR mutation status or patients with squamous cell carcinoma (P=0.021 and P=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. A good ECOG PS (HR=0.52, P=0.018), l-CYFRA 21-1 (HR=0.36, P=0.004), and EGFR mutation (HR=0.53, P=0.051) were independently predictive of longer OS. 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, particularly in patients with unknown EGFR mutation status or patients with squamous cell carcinoma.

journal_name

Exp Ther Med

journal_title

Experimental and therapeutic medicine

authors

Jung M,Kim SH,Lee YJ,Hong S,Kang YA,Kim SK,Chang J,Rha SY,Kim JH,Kim DJ,Cho BC

doi

10.3892/etm.2011.273

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

685-693

issue

eissn

1792-0981

issn

1792-1015

pii

etm-02-04-0685

journal_volume

pub_type

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Prognostic and predictive value of CEA and CYFRA 21-1 levels in advanced non-small cell lung cancer patients treated with gefitinib or erlotinib.