Aim: To investigate potential associations between selected oncomarkers [carcinoembryonic antigen (CEA), CYFRA), and squamous cell carcinoma antigen (SCC)] and outcomes in patients with NSCLC treated with bevacizumab plus chemotherapy. Patients and Methods: We retrospectively analysed 105 patients with NSCLC from the Czech TULUNG registry treated at University Hospital in Pilsen with bevacizumab plus chemotherapy. Response to therapy was tested by Fisher's exact test. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis. Results: Only normal values of CYFRA (not CEA or SCC) were associated with significantly better overall and progression-free survival in univariate analysis. We also observed a trend for a better disease control rate in patients with normal levels of CYFRA. In a multivariate Cox model, only CYFRA was associated with significantly better overall but not progression-free survival. Conclusion: In our retrospective study, we point out the possibility of using CYFRA as a prognostic marker in patients with NSCLC treated with chemotherapy plus bevacizumab.
Background/Aim: Circulating tumour DNA (ctDNA) represents an emerging biomarker in non-small cell lung cancer (NSCLC). We focused on the combination of ctDNA and positron emission tomography/computed tomography (PET/CT) in the follow-up monitoring of advanced-stage NSCLC patients treated with chemotherapy. Patients and Methods: Eighty-four patients were enrolled in this study. 18 F-fluorodeoxyglucose PET/CT and ctDNA assessments were performed at baseline and after two cycles of chemotherapy (follow-up). Results: There was a correlation of ctDNA with metabolic tumour volume (MTV), total lesion glycolysis (TLG), and iodine concentration (IC) at baseline (p=0.001, p=0.001, p=0.003) and at follow-up (p=0.006, p=0.002, p=0.001). The objective response was associated with follow-up ctDNA (p<0.001) and the change of all PET/CT parameters. ROC analyses showed that the combination of follow-up ctDNA with changes in SUVmax is very promising for the estimation of objective response and progression-free survival. Conclusion: The combination of ctDNA assessment with PET/CT is a promising approach for the follow-up monitoring of therapy response and prognosis estimation of advanced-stage NSCLC patients.Lung cancer is one of the leading cancer-related causes of morbidity and mortality worldwide (1, 2), with non-small cell lung cancer (NSCLC) being the most common histological type, representing more than 80% of all cases (3). The management of locally advanced or metastatic NSCLC has been markedly changing in recent years with the introduction of targeted therapies and immune checkpoint inhibitors leading to significant improvements in patient survival. The establishment of personalised medicine based on molecular biomarkers has also brought a significant progress. Despite great advances in the field of therapeutic strategies, it is apparent that further progress is needed in the development of novel diagnostic tools enabling precision monitoring or prediction of therapy response. Notably a precision assessment of early therapy response could enable modification of the treatment strategy to prevent patients from staying on an ineffective therapy.
Purpose: To investigate potential associations between selected laboratory markers (CRP, LDH, albumin, sodium, hemoglobin, neutrophils, and neutrophils/lymphocytes ratio [NLR]) and outcomes in patients with non-small cell lung cancer (NSCLC) treated with bevacizumab (BEV) plus chemotherapy. Patients and Methods: We retrospectively analyzed 105 patients with NSCLC from the Czech TULUNG registry treated at University Hospital in Pilsen with BEV + chemotherapy. Response to therapy was tested by Fisher's exact test. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis. Results: We showed significantly better disease control rate when CRP, albumin, hemoglobin, and NLR were within established “normal” values. In univariate analysis, normal values of CRP, LDH, albumin, sodium, hemoglobin, neutrophils, and NLR were associated with better overall survival (OS). Normal values of CRP, albumin, hemoglobin, neutrophils, and NLR were associated also with better progression-free survival (PFS). In a multivariate Cox model, normal values of LDH, albumin, and NLR were associated with significantly better OS while normal CRP, albumin, and NLR were associated with better PFS. Conclusions: LDH and sodium appear to be possible prognostic markers for BEV treatment in combination with chemotherapy in NSCLC. The parameters associated with inflammatory response (CRP, NLR, albumin, and possibly hemoglobin) appear to be promising predictive markers for this treatment combination.
Purpose: To investigate potential association between selected tumor markers and laboratory parameters (lactate dehydrogenase [LDH], neutrophils, hemoglobin, neutrophils, lymphocytes, C-reactive protein, albumin, carcinoembryonic antigen, and cytokeratin 19 fragment 21-1 [CYFRA 21-1]) and circulating tumor DNA (ctDNA) with survival in patients with advanced non-small cell lung cancer (NSCLC). Patients and Methods: The study encompassed 82 patients from a single center. All patients had (localy-) advanced adenocarcinomas. ctDNA was determined before starting therapy and at 6 weeks follow-up. Laboratory parameters were measured before each cycle of therapy and oncomarkers before starting the therapy as standard clinical practice. Mann-Whitney U test, Cox proportional hazards model, Fisher's exact test, and Kaplan-Meier survival estimation with Gehan-Wilcoxon test were used for statistical analysis of the corresponding variables. Results: We have confirmed predictive or prognostic significance for some of the selected laboratory markers and oncomarkers. Above all, we demonstrate a significant relationship between the levels of LDH and the oncomarker CYFRA 21-1 and the presence or absence of ctDNA at the time of diagnosis. We also demonstrate significantly lower CRP levels in patients within whom the ctDNA disappeared during treatment. A similar but statistically insignificant trend was observed for LDH. Conclusions: CYFRA 21-1, LDH and probably CRP correlate with ctDNA levels in NSCLC. Repeated measurement of these markers could thus help in early detection of disease progression in the same way as does ctDNA monitoring.
Background/Aim: This study aimed at contributing to a better diagnosis of lung cancer by analyzing the patient’s symptoms and their linkage to other characteristics. Patients and Methods: We analyzed the data of 3,322 patients from LUCAS (LUngCAncerfocuS) National Registry of the Czech Republic. Overall survival was assessed using the Kaplan–Meier method. Results: The most common symptoms were cough (47.5%), dyspnea (45.6%), pain (27.3%), and weight loss (25.7%). Among all patients, 16% were asymptomatic. We demonstrated the negative prognostic significance of increasing number of lung cancer symptoms, that was significant after adjustment for age, TNM stages, and performance status, and morphological types of the cancer. Conclusion: Monitoring the severity and type of symptoms in patients with lung cancer can help in the diagnostics of the disease and the estimation of prognosis.
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