Abstract
The aim of this study has been to investigate the potential of serum biomarkers used in clinical practice (CEA, CYFRA 21–1, SCC) together with the serum epidermal growth factor receptor (EGFR) and its associated ligands (EGF, TGF-α, HB-EGF) as outcome predictors of non-small cell lung cancer (NSCLC) patients treated with the TKI erlotinib. The pretreatment levels of these markers were evaluated through immunoassays carried out in 58 patients. The progression-free survival (PFS) and overall survival (OS) were assessed by the Kaplan-Meier method and differences between groups were compared by means of the Log-Rank test. Association of risk factors with survival was evaluated using the univariate and multivariate Cox modelling procedures. Higher CEA (>5 ng/mL) and sEGFR (>56.87 ng/mL) concentrations associated significantly with a higher overall survival. The pre-treatment sEGFR serum levels constituted an independent prognostic factor. The EGFR gene mutational status and the sEGFR level combination was the single to associate significantly with longer progression-free survival periods, in circumstances in which the EGFR gene was mutated and increased protein serum levels were detected. The overall survival as assessed through a Cox analysis revealed similar death hazards with respect to low sEGFR levels combined both with non-mutated EGFR genotypes and low CEA serum levels. Our results suggest that the pre-treatment CEA and sEGFR serum levels may provide a comparable source of information to that supplied by the EGFR gene mutational status with respect to the prognosis of erlotinib treated NSCLC patients. A combined sEGFR and CEA level appraisal could be of considerable value to select patients to undergo EGFR-TKI treatments.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-015-0891-0) contains supplementary material, which is available to authorized users.
Highlights
Non-small cell lung cancer (NSCLC) cases account for approximately 85% of all the lung cancer instances, with pulmonary carcinomas representing worldwide the leading death cause derived from cancer (Jemal et al 2010)
In this study we have investigated amongst Tyrosine kinase inhibitors (TKI) erlotinib treated non-small cell lung cancer (NSCLC) patients the potential predictive outcome of three clinical practice applied serum biomarkers (CEA, CYFRA 21–1, SCC) together with the soluble form of epidermal growth factor receptor (EGFR) and its constituting ligands: epidermal growth factor (EGF), transforming growth factor-alpha (TGF-α) and heparin binding epidermal growth factor (HB-EGF)
A total of three treatments were administered to only 3.4% of the patients: first and second lines consisted of platinum derivatives and with regard to the third line one patient had received gemcitabine while another had been assigned taxane
Summary
Non-small cell lung cancer (NSCLC) cases account for approximately 85% of all the lung cancer instances, with pulmonary carcinomas representing worldwide the leading death cause derived from cancer (Jemal et al 2010). No EGFR mutations were identified in 10-20% of patients with partial responses to EGFR-TKI application (Pao et al 2004; Lynch et al 2004; Cappuzzo et al 2005; Bell et al 2005; Han et al 2005). This evidence strongly suggests that other mechanisms besides of the EGFR mutation status determine the TKI treatment responsiveness (Chang et al 2011; Cappuzzo et al 2005; Engelman et al 2005). Significant ErbB-3 over-expression levels have been associated with gefitinib sensitivity (Engelman et al 2005)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
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 call
