Abstract
High levels of bone morphogenetic protein (BMPs) have been reported in patients with lung cancer. This study was conducted to assess correlations between serum BMP-2 levels and prognostic outcome in patients with non-small-cell lung cancer (NSCLC). Blood samples from 84 patients with advanced NSCLC and 42 healthy controls were analyzed and quantitated for serum BMP-2 levels before and after two cycles of chemotherapy using a commercially available ELISA kit. The median level of BMP-2 was 146.9 pg/ml in patients with NSCLC vs. 87.7 pg/ml in healthy controls (P<0.01). A significant correlation was observed between pretreatment serum BMP-2 level and ECOG PS, disease stage and number of organs with metastases (P<0.05). Serum BMP-2 level decreased significantly in patients who achieved objective response after two cycles of chemotherapy. Multivariate analysis showed that increased BMP-2 level and advanced clinical stage were significantly correlated with poor prognosis. Thes erum BMP-2 level is positively correlated with clinical stage, ECOG PS and metastatic burden and may serve as an independent negative predictor for prognosis. Decreased BMP-2 after chemotherapy could be a reliable marker for efficacy of treatment.
Highlights
Lung cancer is one of the most common malignant tumors worldwide and the leading cause of human cancerrelated deaths for several decades (Siegel et al, 2013)
This poor prognosis emphasizes the urgent need for accurate prognostic and predictive factors to evaluate the treatment for patients with advanced non-small-cell lung cancer (NSCLC) so as to know earlier whether the tumor responds to the treatment, or the therapeutic regimen should be changed in time (Reich, 2005)
The pathological type was identifiable in 48 (57.1%) patients as adenocarcinoma; 62 (73.8%) patients were diagnosed in the stage IV; 41 (48.9%) patients had Eastern Cooperative Oncology Group (ECOG) PS 0 at the initiation of first-line chemotherapy; 27 (32.1%) patients had more than 3 metastatic organs
Summary
Lung cancer is one of the most common malignant tumors worldwide and the leading cause of human cancerrelated deaths for several decades (Siegel et al, 2013). For patients with advanced NSCLC, the therapeutic option is limited to combination chemotherapy, which is largely ineffective with a response rate ranging from 20% to 35% and a 1-year survival rate of 35% (Ohe et al, 2007). This poor prognosis emphasizes the urgent need for accurate prognostic and predictive factors to evaluate the treatment for patients with advanced NSCLC so as to know earlier whether the tumor responds to the treatment, or the therapeutic regimen should be changed in time (Reich, 2005). Phosphorylated Smad 1/5/8 forms a complex with Smad 4 and translocates to the nucleus to activate the transcription of downstream targets, such as alkaline phosphatase (ALP), runt-related transcription factor 2 (Runx2), and osteocalcin (Miyazono, 2002; Hocking and McFarlane, 2007)
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