We have evaluated CYFRA 21-1 serum level variations as an indicator of tumor response and survival in 44 consecutive patients with locally advanced non-small cell lung cancer (NSCLC) treated with induction chemotherapy (IC). Irrespective of the initial CYFRA 21-1 serum concentration, a more than 65% decrease in the serum level after the first chemotherapy course was significantly predictive of an objective tumor response (p=0.0022). In addition, a more than 80% decrease in this level significantly predicted a better disease-free survival (p=0.039). In patients with initial CYFRA 21-1 serum levels >3.3 ng/mL (n=29), a more than 80% decrease after the first IC course was the most significant predictor of overall survival (p=0.025) in a Cox analysis including initial staging, tumor response and surgery. We conclude that early monitoring of CYFRA 21-1 serum levels may be a useful prognostic tool for tumor response and survival in stage III NSCLC patients treated by induction chemotherapy.
MollR., FrankeW.W., SchillerD.L., GeigerB., KreplerR.. The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells.Cell1982; 31: 11–24.
2.
BroersJ.L., RamaekersF.C., RotM.K.. Cytokeratins in different types of human lung cancer as monitored by chain-specific monoclonal antibodies.Cancer Res1998; 48: 3221–9.
3.
BrawerM.K., NagleR.B., PittsW., FreihaF., GambleS.L.. Keratin immunoreactivity as an aid to the diagnosis of persistent adenocarcinoma in irradiated human prostates.Cancer1989; 63: 454–60.
4.
BroersJ.L., RotM.K., OostendorpT.. Immunocytochemical detection of human lung cancer heterogeneity using antibodies to epithelial, neuronal, and neuroendocrine antigens.Cancer Res1987; 47: 3225–34.
5.
PujolJ.L., GrenierJ., DauresJ.P., DaverA., PujolH., MichelF.B.. Serum fragment of cytokeratin subunit 19 measured by CYFRA 21-1 immunoradiometric assay as a marker of lung cancer.Cancer Res1993; 53: 61–6.
6.
TubianaM.. The growth and progression human tumors: implications for management strategy.Radiother Oncol1986; 6: 167–84.
7.
Van Der GaastA., SchoenmakersC.H., KokT.C., BlijenbergB.G., CornillieF., SplinterT.A.. Evaluation of a new tumour marker in patients with non-small-cell lung cancer: CYFRA 21–1.Br J Cancer1994; 69: 525–8.
8.
BréchotJ.M., NatafJ., FrétaultJ.. Evaluation of a new serum tumor marker CYFRA 21-1 for the diagnosis and prognosis of non small cell lung cancer (NSCLC): preliminary results.Lung Cancer1994; 11(Suppl 1): 40 (abstract 152).
9.
WHO.The World Health Organization histological typing of lung tumours. Second edition.Am J Clin Pathol1982; 77: 123–36.
10.
MountainC.F.. Revisions in the International System for Staging Lung Cancer.Chest1997; 111: 1710–7.
11.
JanicotH., NguyenL., PorthaultE.. Chemotherapy with cisplatinum (CDDP), ifosfamide (IFM) and vinorelbine (VNB) in stage III B, IV non small cell lung cancer (NSCLC).Lung Cancer1997; 18(Suppl 1): 36 (abstract 129).
12.
RouxD., TaiarM., BayJ.O.. Neoadjuvant chemotherapy ifosfamide etoposide and cisplatin (VIP) in 50 patients with non small cell lung cancer (NSCLC).Lung Cancer1997; 18(Suppl 1): 54 (abstract 208).
13.
World Health Organization.WHO handbook for reporting results of cancer treatment.Geneva (Switzerland): World Health Organization, Offset Publication1979; chapter 48.
14.
StieberP., HasholznerU., BodenmullerH.. CYFRA 21–1. A new marker in lung cancer.Cancer1993; 72: 707–13.
15.
KwiatkowskiF., GirardM., HaceneK., BerlieJ.. Sem: a suitable statistical software adaptated for research in oncology.Bull Cancer2000; 87: 715–21.
16.
KwiatkowskiF., GachonF., CharrierS., Sancho-GarnierH., KramarA.. Decision making in biology: ROC analysis.Bull Cancer1999; 86: 787–9.
17.
HamzaouiA., ThomasP., CastelnauO., RouxN., RouxF., KleisbauerJ.P.. Usefulness of longitudinal evaluation of CYFRA 21-1 variations in advanced lung cancer monitoring.Lung Cancer1997; 16: 191–202.
18.
RosellR., GatzemeierU., BetticherD., KepplerU.. Phase III randomised trial comparing paclitaxel/carboplatin with paclitaxel/cisplatin in patients with advanced non-small-cell lung cancer: a cooperative multinational trial.Ann Oncol2000; 13: 1539–44.
19.
RinaldiM., CrinoL.. Induction chemotherapy with gemcitabine and cisplatin in stage III non-small cell lung cancer.Lung Cancer2001; 34(Suppl 4): S25–S30.
20.
YoshiokaT., TakahashiH., OikawaH.. Influence of chemotherapy on FDG uptake by human cancer xenografts in nude mice.J Nucl Med1997; 38: 714–7.
21.
ShieldsA., MankoffD., LinkJ.. Carbon-11 thymidine and FDG to measure therapy response.J Nucl Med1998; 39: 1757–62.
22.
KostakogluL., ColemanM., LeonardJ., KujiI., ZoeH., GoldsmithS.. PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin's disease.J Nucl Med2002; 43: 1028–30.
23.
WeberW.A., PetersenV., SchmidtB., Tyndale-HinesL., PescheC., SchwaigerM.. Positron emission tomography in non-small-cell lung cancer: prediction of response to chemotherapy by quantitative assessment of glucose use.J Clin Oncol2003; 21: 2651–7.
