P2.01-077 Serum CYFRA 21-1 and CEA Level as a Predicting Marker for Advanced Non-Small Cell Lung Cancer

Abstract

Tumor markers such as CEA and CYFRA 21-1 have been shown to be effective in patients with non-small cell lung cancer as an aid in diagnosis and monitoring response to treatment. CYFRA 21-1 is a fragment of cytokeratin 19, presented in the cytoplasm of tumor cells of epithelial origin. CEA or Carcino-Embryonic Antigen is a cell surface protein. We recruited advanced non-small cell lung cancer patients who received first line treatment with standard chemotherapy between February and September 2015 in Maharaj Nakorn ChiangMai hospital. Excluded criteria were patients who had history of other active cancers and who had end stage renal disease (confounding factors to serum CYFRA measurement). Clinical data was obtained and a blood sample was collected at baseline, after start chemotherapy at cycle 2nd and at the end of treatment. Serum tumor marker levels were determined with a test kit (Roche Diagnostics Corp) using a Cobas e 411 analyzer. Primary objective outcome is correlation in dynamic change of serum CYFRA and CEA level compare to clinical response from radiologic assessment. Secondary objective outcome Secondary objective outcome is optimal cut point to predict the treatment outcome from sensitivity and specificity analysis. Multivariable logistic regression analysis was used to identify the effect of changed value of CYFRA-21. C-statistic was used to identify the optimal cut of point of changed value of CYFRA-21 to predict the outcome of treatment demonstrated by area under receiver operating characteristic curve (AuROC). The p-value < 0.05 was considered statistically significant. All statistical analysis was performed using STATA program (version 12.0). Forty patients (24 males and 16 females) were enrolled. The median age was 59.8 years. Histology subtypes were adenocarcinoma (70%), squamous cell (22.5%), large cell carcinoma (5%) and NOS(not otherwise specified) (2.5%). The treatment responses were partial response (50%), stable of disease (27.5%) and progression of disease (22.5%). The result demonstrated significant correlation between dynamic change of serum CYFRA level and clinical benefit from radiologic assessment. Mean change value of CYFRA-21 before and after treatment between clinical beneficial group (PR + SD) and PD group were -7.7±9.2 and 12.5±23.2 respectively (p<0.001). In contrast dynamic change of serum CEA did not show significant correlation.For secondary end point, at cut point of 2 ng/ml reduction of CYFRA level after treatment had the most accepted from AuROC curve. CYFRA 21-1 have capability to predict benefit of treatment from chemotherapy in non-small cell lung cancer.