The role of neuron-specific enolase (NSE) and thymidine kinase (TK) levels in prediction of efficacy ofEGFR-TKIs in patients with advanced-stage NSCLC [corrected]

Abstract

Background/aim: Tumor biomarkers are used for diagnostics and follow-up monitoring of patients with non-small cell lung cancer (NSCLC). We focused on the predictive role of neuron-specific enolase (NSE) and thymidine [corrected] kinase (TK) in patients with advanced-stage NSCLC treated with epidermal growth factor tyrosine kinase inhibitors (EGFR-TKIs).

Patients and methods: In a total of 163 patients with advanced-stage (IIIB or IV) NSCLC treated with EGFR-TKIs (erlotinib or gefitinib), pre-treatment levels of NSE and TK were measured.

Results: We observed significantly shorter progression-free (PFS) and overall survival (OS) in patients with high NSE levels (p=0.002; p=0.003) and also in those with high TK levels (p=0.026; p=0.020). The multivariate Cox proportional hazards model confirmed that high NSE is a strong independent predictive factor for short PFS (hazard ratio; HR=2.36; p=0.003).

Conclusion: High pre-treatment serum levels of NSE is an independent biomarker predicting poor outcome of patients with NSCLC treated with EGFR-TKIs.

Keywords: EGFR-TKI; NSCLC; NSE; Predictive biomarkers; TK.