Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis

Arrieta, Óscar; Saavedra-Pérez, David; Kuri, Roberto; Avilés‐Salas, Alejandro; Martinez, Luis; Mendoza-Posada, Daniel; Castillo, Patricia; Astorga, Alma; Guzman, Enrique; Garza, Jaime de la

doi:10.1186/1471-2407-9-119

Cited by 128 publications

(116 citation statements)

References 47 publications

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“…However, no significant correlations between the overexpression of ErbB receptor family members and clinical pathological parameters, including OS time, were observed (24). By contrast, a prospective study assessing the development of brain metastasis in 293 patients with advanced NSCLC reported that EGFR expression (RR, 1.6; 95% CI, 1.4-1.9; P=0.012) was independently associated with a shorter OS time (25). Similarly, a report from a retrospective cohort of patients with NSCLC that assessed HER2 levels demonstrated a higher objective response rate among patients that overexpressed HER2 and were treated with trastuzumab (26).…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of the EGFR immunohistochemistry scores for tumor samples from patients with advanced non-small cell lung cancer

et al. 2016

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Abstract. Epidermal growth factor receptor (EGFR) is overexpressed in >60% of non-small cell lung cancer (NSCLC) cases. In combination with radiotherapy or chemotherapy, first-line treatments with antibodies against EGFR, including cetuximab and necitumumab, have demonstrated benefits by increasing overall survival (OS), particularly in patients who overexpress EGFR. The present study evaluated the interobserver agreement among three senior pathologists, who were blinded to the clinical outcomes and assessed tumor samples from 85 patients with NSCLC using the H-score method. EGFR immunohistochemistry was performed using a qualitative immunohistochemical kit. The reported (mean ± standard deviation) H-scores from each pathologist were 111±102, 127±103 and 128.53±104.03. The patients with average H-scores ≥1, ≥100, ≥200 and between 250-300 were 85.9, 54.1, 28.2 and 12.9, respectively. Patients who had an average H-score >100 had a shorter OS time compared with those with lower scores. Furthermore, patients with EGFR mutations who were treated with EGFR-tyrosine kinase inhibitors (TKIs) and had an average H-score >100 had a longer OS time compared with those with an average H-score <100. The interobserver concordance for the total H-scores were 0.982, 0.980 and 0.988, and for a positive H-score ≥200, the interobserver concordance was 0.773, 0.710 and 0.675, respectively. The determination of EGFR expression by the H-score method is highly reproducible among pathologists and is a prognostic factor associated with a poor OS in all patients. Additionally, the results of the present study suggest that patients with EGFR mutations that are treated with EGFR-TKIs and present with a high H-score have a longer OS time.

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Section: Discussionmentioning

confidence: 99%

Reproducibility of the EGFR immunohistochemistry scores for tumor samples from patients with advanced non-small cell lung cancer

et al. 2016

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“…Preoperative values of CEA, even within their normal range (0 -5 ng mL ), are related to worse prognoses [71]. Although serum CEA assays have low sensitivity and specificity for diagnosing lung cancers [72], several studies have reported statistically significant evidence for the use of CEA as a prognostic marker in NSCLC patients, but not for SCLC patients [73][74][75][76][77].…”

Section: Lung Cancer Protein Biomarkers In Serum: Current Statusmentioning

confidence: 99%

Serum-based protein biomarkers for detection of lung cancer

2014

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Lung cancer is one of the most common cancers in terms of both incidence and mortality.The major reasons for the increasing number of deaths from lung cancer are late detection and lack of effective therapies. To improve our understanding of lung cancer biology, there is urgent need for blood-based, non-invasive molecular tests to assist in its detection in a cost-effective manner at an early stage when curative interventions are still possible. Recent advances in proteomic technology have provided extensive, high throughput analytical tools for identification, characterization and functional studies of proteomes. Changes in protein expression patterns in response to stimuli can serve as indicators or biomarkers of biological and pathological processes as well as physiological and pharmacological responses to drug treatment, thus aiding in early diagnosis and prognosis of disease. However, only a few biomarkers have been approved by the FDA to date for screening and diagnostic purposes. This review provides a brief overview of currently available proteomic techniques, their applications and limitations and the current state of knowledge about important serum biomarkers in lung cancer and their potential value as prognostic and diagnostic tools.

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“…CEA is an oncofetal protein attached to epithelial cell apical membrane via its C-terminal glycosylphosphatidylinositol anchor, a member of the immunoglobulin superfamily of cell adhesion molecules (17). Usually, CEA is overexpressed in a variety of neoplasms, such as colorectal, breast, bladder, gastric, pancreatic and lung carcinomas (16). CEA is a good monitoring marker for conventional chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…It appears more sensitive and more specific than other tumor markers, such as CEA and NSE, and slightly better than squamous cell carcinoma-antigen (SCC) in squamous cell carcinoma (15). CEA is a glycoprotein expressed during early fetal life, and is the product of the CEACAM5-gen (16). CEA is an oncofetal protein attached to epithelial cell apical membrane via its C-terminal glycosylphosphatidylinositol anchor, a member of the immunoglobulin superfamily of cell adhesion molecules (17).…”

Section: Discussionmentioning

confidence: 99%

Declines in serum CYFRA21-1 and carcinoembryonic antigen as predictors of chemotherapy response and survival in patients with advanced non-small cell lung cancer

Yang

Chen

et al. 2010

Experimental and Therapeutic Medicine

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Abstract. The aim of this study was to investigate the clinical value of serum cytokeratin 19 fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) in the prediction of chemotherapy response and prognosis in patients with advanced non-small cell lung cancer (NSCLC). Serum CYFRA21-1 and CEA levels of 98 patients with advanced NSCLC were measured using immunoradiometric kits prior to and after 2 cycles of chemotherapy. After 2 cycles of chemotherapy, 45 patients achieved a radiological objective response (OR), 30 patients achieved stable disease (SD) and 23 patients had progressive disease (PD). Serum CYFRA21-1 and CEA were significantly decreased compared to baseline levels (P<0.001). By ROC curve analysis, a ≥60% reduction in CYFRA21-1 and a ≥25% reduction in CEA were the optimal cut-off levels with best sensitivity and specificity for the diagnosis of radiologic OR. The median survival of all patients was 10.2 months (range 2.6-26.3). Univariate survival analysis showed that the Eastern Cooperative Oncology Group (ECOG) performance status (PS) score, radiologic OR, a ≥60% reduction in CYFRA21-1 and a ≥25% reduction in CEA were significant prognostic factors for better overall survival. The median overall survival time in patients with a ≥60% reduction in CYFRA21-1 was significantly longer than in those with a <60% reduction (P<0.001). Similarly, the median overall survival time in patients with a ≥25% reduction in CEA was also significantly longer than in those with a <25% reduction (P<0.001). Multivariate analysis showed that ECOG PS score, a ≥60% reduction in CYFRA21-1 and a ≥25% reduction in CEA were independent prognostic factors of survival, while radiologic OR was not. In conclusion, a ≥60% reduction in CYFRA21-1 and a ≥25% reduction in CEA may be reliable surrogate markers for the prediction of chemothrapy response and prognosis, especially for the diagnosis of radiologic OR.

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Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis

Cited by 128 publications

References 47 publications

Reproducibility of the EGFR immunohistochemistry scores for tumor samples from patients with advanced non-small cell lung cancer

Reproducibility of the EGFR immunohistochemistry scores for tumor samples from patients with advanced non-small cell lung cancer

Serum-based protein biomarkers for detection of lung cancer

Declines in serum CYFRA21-1 and carcinoembryonic antigen as predictors of chemotherapy response and survival in patients with advanced non-small cell lung cancer

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