Background: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the standard first-line treatment regimen for EGFR mutated non-small cell lung cancer (NSCLC) patients. However, the efficacy of EGFR-TKIs widely varies. The aim of this study is to determine whether the pretreatment serum cytokeratin-19 fragments (CYFRA21-1) and carcinoembryonic antigen (CEA) are associated with the efficacy of EGFR-TKIs in EGFR-mutated NSCLC patients.
Methods: We retrospectively enrolled 194 NSCLC patients harboring EGFR mutations who received EGFR-TKIs. Clinical characteristics were collected, and the relation between the efficacy of EGFR-TKIs and pretreatment serum CYFRA21-1 and CEA was analyzed.
Results: In all cases, progression-free survival (PFS) in patients with high CYFRA21-1 level was significantly shorter than PFS in patients with normal CYFRA21-1 (7.0 vs 11.9 months, P<0.001). Overall survival (OS) in patients with high CYFRA21-1 was significantly shorter than in the normal-CYFRA21-1 group (12.6 vs 28.0 months, P<0.001). In adenocarcinoma patients, PFS in the high-CYFRA21-1 level group was significantly shorter than in patients with normal CYFRA21-1 (7.0 vs 12.0 months, P<0.001). OS in patients with high CYFRA21-1 was significantly shorter than that in the normal-CYFRA21-1 group (13.1 vs 28.1 months, P<0.001). Among squamous carcinoma patients, CYFRA21-1 level did not affect survival. No significant difference in PFS and OS was observed between patients with high CEA and patients with normal CEA.
Conclusions: EGFR-mutated patients with high CYFRA21-1 had significantly shorter PFS and OS than patients with normal CYFRA21-1 after receiving EGFR-TKIs. Pretreatment serum CYFR21-1 level was a predictive marker of EGFR-TKI treatment in EGFR-mutated NSCLC patients. .
背景与目的 表皮生长因子受体-酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitors, EGFR-TKIs）是EGFR基因突变晚期非小细胞癌（non-small cell lung cancer, NSCLC）患者一线标准治疗方案，但是临床实践中，疗效差异较大。本项实验拟研究治疗前血清细胞角蛋白19片段（cytokeratin-19 fragments, CYFRA21-1）和癌胚抗原（carcinoembryonic antigen, CEA）的水平是否与EGFR-TKIs疗效有关。方法 回顾性分析194例EGFR基因突变阳性且接受EGFR-TKIs治疗的NSCLC患者的治疗前的血清CYFRA21-1和CEA水平与EGFR-TKIs疗效及生存时间的关系。结果 血清水平CYFRA21-1增高和正常的无进展生存时间（progression-free survival, PFS）分别为7.0个月和11.9个月（P<0.001）；总生存（overall survival, OS）分别为12.6个月和28.0个月（P<0.001）。腺癌中，血清水平增高和正常的PFS分别为7.0个月和12.0个月（P<0.001），OS分别为13.1个月和28.1个月（P<0.001）。鳞癌中，血清CYFRA21-1水平高低与生存时间无关。治疗前血清CEA水平高低与生存时间无关。结论 在EGFR突变肺腺癌患者，治疗前血清水平CYFRA21-1增高组EGFR-TKIs治疗的PFS和OS均较正常组短。EGFR突变肺腺癌患者，治疗前血清CYFRA21-1水平可以作为预测EGFR-TKIs治疗的疗效指标。.