Abstract
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 >or=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, >or=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 >or=35% decline seems to be a reliable surrogate marker of treatment efficacy in terms of survival.
MeSH terms
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Adenocarcinoma / blood
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Adenocarcinoma / drug therapy
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Adenocarcinoma / mortality
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Adult
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Aged
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Antigens, Neoplasm / blood*
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Biomarkers, Tumor / blood*
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Carcinoma, Large Cell / blood
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Carcinoma, Large Cell / drug therapy
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Carcinoma, Large Cell / mortality
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Carcinoma, Non-Small-Cell Lung / blood*
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Carcinoma, Non-Small-Cell Lung / drug therapy
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Carcinoma, Non-Small-Cell Lung / mortality
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Carcinoma, Squamous Cell / blood
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Carcinoma, Squamous Cell / drug therapy
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Carcinoma, Squamous Cell / mortality
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Female
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Humans
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Keratin-19
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Keratins / blood*
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Lung Neoplasms / blood*
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Lung Neoplasms / drug therapy
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Lung Neoplasms / mortality
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Male
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Middle Aged
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Neoplasm Staging
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Prognosis
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Prospective Studies
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Survival Rate
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Treatment Outcome
Substances
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Antigens, Neoplasm
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Biomarkers, Tumor
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Keratin-19
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antigen CYFRA21.1
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Keratins