Thomas Muley1, Vinzent Rolny2, Ying He3, Birgit Wehnl4, Achim Escherich5, Arne Warth6, Christa Stolp7, Marc A Schneider8, Hendrik Dienemann9, Michael Meister10, Felix J Herth11, Farshid Dayyani12. 1. Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany; Translational Lung Research Center, Member of the German Center for Lung Research (DZL), Heidelberg, Germany. Electronic address: thomas.muley@med.uni-heidelberg.de. 2. Roche Diagnostics GmbH, Penzberg, Germany. Electronic address: vinzent.rolny@roche.com. 3. Roche Diagnostics GmbH, Penzberg, Germany. Electronic address: ying.he@roche.com. 4. Roche Diagnostics GmbH, Penzberg, Germany. Electronic address: birgit.wehnl@roche.com. 5. Roche Diagnostics International Ltd., Rotkreuz, Switzerland. Electronic address: achim.escherich@roche.com. 6. Translational Lung Research Center, Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Pathological Institute, University of Heidelberg, Heidelberg, Germany. Electronic address: warth@patho-uegp.de. 7. Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany. Electronic address: Christa.stolp@med.uni-heidelberg.de. 8. Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany; Translational Lung Research Center, Member of the German Center for Lung Research (DZL), Heidelberg, Germany. Electronic address: Marc.schneider@med.uni-heidelberg.de. 9. Translational Lung Research Center, Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Department of Thoracic Surgery, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany. Electronic address: hendrik.dienemann@med.uni-heidelberg.de. 10. Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany; Translational Lung Research Center, Member of the German Center for Lung Research (DZL), Heidelberg, Germany. Electronic address: Michael.Meister@med.uni-heidelberg.de. 11. Translational Lung Research Center, Member of the German Center for Lung Research (DZL), Heidelberg, Germany; Department of Pneumology and Critical Care Medicine, Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany. Electronic address: felix.herth@med.uni-heidelberg.de. 12. Roche Diagnostics International Ltd., Rotkreuz, Switzerland. Electronic address: fdayyani@uci.edu.
Abstract
OBJECTIVES: To determine whether the tumor biomarkers cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA), which are prognostic in early-stage non-small cell lung cancer (NSCLC), can predict which patients benefit from adjuvant chemotherapy (CTx). MATERIALS AND METHODS: Serum samples were collected preoperatively from patients with NSCLC who underwent resection. Samples were retrospectively analyzed for CYFRA 21-1 and CEA via electrochemiluminescence immunoassay. Recurrence-free survival (RFS) was compared for patients who received adjuvant CTx versus surgery alone, stratified based on the following prognostic classifications: (1) tumor stage (pT1-2/N0 [stage I] or pT3/N0 or pT1-2/N1 [stage II]), (2) biomarker-based risk score, (3) clinical characteristics. Absolute 2-year RFS rates were calculated via Kaplan-Meier estimations; statistical significance level: 0.05. RESULTS: 227 patients were included (stage I: 69%; male: 67%; median age 65 years); 70 received adjuvant CTx. Median duration of sample collection was 58.8 months. All high-risk patients (by all three prognostic classifications) who received adjuvant CTx had a longer RFS versus those who received surgery alone. In patients with squamous cell carcinoma (SCC) classified as high risk by all three prognostic classifications, there was a benefit from adjuvant CTx versus surgery alone (tumor stage hazard ratio [HR] 4.9, p = 0.004; biomarker levels HR 9.4, p = 0.002; clinical characteristics HR 9.0, p = 0.003). None of the prognostic classifications were able to predict a benefit from adjuvant CTx in patients with adenocarcinoma. CONCLUSION: Baseline CYFRA 21-1 and CEA levels may provide further information to help clinicians decide which patients with SCC should receive adjuvant CTx. Further evaluation of these biomarkers is warranted.
OBJECTIVES: To determine whether the tumor biomarkers cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA), which are prognostic in early-stage non-small cell lung cancer (NSCLC), can predict which patients benefit from adjuvant chemotherapy (CTx). MATERIALS AND METHODS: Serum samples were collected preoperatively from patients with NSCLC who underwent resection. Samples were retrospectively analyzed for CYFRA 21-1 and CEA via electrochemiluminescence immunoassay. Recurrence-free survival (RFS) was compared for patients who received adjuvant CTx versus surgery alone, stratified based on the following prognostic classifications: (1) tumor stage (pT1-2/N0 [stage I] or pT3/N0 or pT1-2/N1 [stage II]), (2) biomarker-based risk score, (3) clinical characteristics. Absolute 2-year RFS rates were calculated via Kaplan-Meier estimations; statistical significance level: 0.05. RESULTS: 227 patients were included (stage I: 69%; male: 67%; median age 65 years); 70 received adjuvant CTx. Median duration of sample collection was 58.8 months. All high-risk patients (by all three prognostic classifications) who received adjuvant CTx had a longer RFS versus those who received surgery alone. In patients with squamous cell carcinoma (SCC) classified as high risk by all three prognostic classifications, there was a benefit from adjuvant CTx versus surgery alone (tumor stage hazard ratio [HR] 4.9, p = 0.004; biomarker levels HR 9.4, p = 0.002; clinical characteristics HR 9.0, p = 0.003). None of the prognostic classifications were able to predict a benefit from adjuvant CTx in patients with adenocarcinoma. CONCLUSION: Baseline CYFRA 21-1 and CEA levels may provide further information to help clinicians decide which patients with SCC should receive adjuvant CTx. Further evaluation of these biomarkers is warranted.
Authors: Marc A Schneider; Thomas Muley; Rebecca Weber; Sabine Wessels; Michael Thomas; Felix J F Herth; Nicolas C Kahn; Ralf Eberhardt; Hauke Winter; Gudula Heussel; Arne Warth; Christel Herold-Mende; Michael Meister Journal: Cancers (Basel) Date: 2018-12-04 Impact factor: 6.639
Authors: Filippo G Dall'Olio; Francesca Abbati; Francesco Facchinetti; Maria Massucci; Barbara Melotti; Anna Squadrilli; Sebastiano Buti; Francesca Formica; Marcello Tiseo; Andrea Ardizzoni Journal: Ther Adv Med Oncol Date: 2020-10-31 Impact factor: 8.168