Abstract
BackgroundCentral nervous system is a common site of metastasis in NSCLC and confers worse prognosis and quality of life. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), serum CEA levels, and EGFR and HER2 tissue-expression in brain metastasis (BM) and overall survival (OS) in patients with advanced NSCLC.MethodsIn a prospective manner, we studied 293 patients with NSCLC in IIIB-IV clinical stage. They received standard chemotherapy. CEA was measured prior to treatment; EGFR and HER2 were evaluated by immunohistochemistry. BM development was confirmed by MRI in symptomatic patients.ResultsBM developed in 27, and 32% of patients at 1 and 2 years of diagnosis with adenocarcinoma (RR 5.2; 95% CI, 1.002–29; p = 0.05) and CEA ≥ 40 ng/mL (RR 11.4; 95% CI, 1.7–74; p < 0.01) as independent associated factors. EGFR and HER2 were not statistically significant. Masculine gender (RR 1.4; 95% CI, 1.002–1.9; p = 0.048), poor performance status (RR 1.8; 95% CI, 1.5–2.3; p = 0.002), advanced clinical stage (RR 1.44; 95% CI, 1.02–2; p = 0.04), CEA ≥ 40 ng/mL (RR 1.5; 95% CI, 1.09–2.2; p = 0.014) and EGFR expression (RR 1.6; 95% CI, 1.4–1.9; p = 0.012) were independent associated factors to worse OS.ConclusionHigh CEA serum level is a risk factor for BM development and is associated with poor prognosis in patients with advanced NSCLC. Surface expression of CEA in tumor cells could be the physiopathological mechanism for invasion to CNS.
Highlights
Central nervous system is a common site of metastasis in non-small cell lung cancer (NSCLC) and confers worse prognosis and quality of life
The objective of this study was to evaluate prospectively manner the prognostic significance of clinical-pathological factors, serum CEA levels, and EGFR and HER2 lung expression in brain metastasis development and overall survival (OS) in patients with recent diagnosis of advanced NSCLC treated with platin-based cytotoxic chemotherapy or EGFR inhibitors
Seventy one percent of patients were diagnosed in a metastatic stage, and 29% were in IIIB clinical stage
Summary
Central nervous system is a common site of metastasis in NSCLC and confers worse prognosis and quality of life. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), serum CEA levels, and EGFR and HER2 tissueexpression in brain metastasis (BM) and overall survival (OS) in patients with advanced NSCLC. The objective of this study was to evaluate prospectively manner the prognostic significance of clinical-pathological factors, serum CEA levels, and EGFR and HER2 lung expression in brain metastasis development and OS in patients with recent diagnosis of advanced NSCLC (clinical stage IIIB-IV) treated with platin-based cytotoxic chemotherapy or EGFR inhibitors. Age [3], clinical stage [6], gender [7], and initial treatment period [8] are some of the reported with CNS metastasis development-related factors in patients with NSCLC; due to their lack of specificity, we are required to detect biomarkers to predict brain metastasis in patients with NSCLC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
