Prognostic Role for CYFRA 21-1 in Patients With Advanced-stage NSCLC Treated With Bevacizumab Plus Chemotherapy

Svatoň, Martin; Blažek, Jiří; Krákorová, Gabriela; Pešek, Miloš; Buresova, Marcela; Teufelova, Zuzana; Vodička, J; Hurdalkova, Karolina; Bařinová, Magda; Topolčan, Ondřej

doi:10.21873/anticanres.14974

Cited by 8 publications

(5 citation statements)

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“… 22 In addition, Svaton et al described a poorer prognosis for patients carrying a KRAS mutation, especially G12 C , compared to the wildtype gene. 23 In contrast, Cui et al found no difference between the 65 G12 C mutants and 79 other patients carrying a KRAS mutation in their study of 346 patients with NSCLC (HR, 1.19; 95% CI, .78-1.80, P = 0, 39). 24 Spira et al found no survival disadvantage for G12 C in a retrospective study of over 7,000 patients with NSCLC.…”

Section: Discussionmentioning

confidence: 88%

Retrospective Data Analysis of Patients With Metastatic Lung Adenocarcinoma With or Without KRAS-Mutation or TTF1-Expression

2022

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Introduction Patients with lung adenocarcinoma not expressing TTF1 and those with a KRAS mutation have worse prognosis. However, available data are limited and sometimes contradictory. Therefore, this retrospective cohort analysis aimed to clarify whether there was a difference in overall survival and progression-free survival between these groups of patients. Methods In total, data derived from 181 patients with metastatic lung adenocarcinoma treated at the Martha-Maria Halle-Dölau Hospital from 2016 to 2019 were analyzed. Kaplan-Meier curves were generated, and associated values, such as median survival and its confidence intervals, were determined using the log-rank test. Results A benefit in overall survival (OS) (8.4 vs 5.8 months; HR, .8; 95% CI, .53-1.19; P = .267) was associated with positive TTF1 expression, but this was not statistically significant. The same trend was shown with the progressive free survival (PFS) (6.5 vs 4.6 months; HR, .76; 95% CI, .51-1.20; P = .162). In patients with a KRAS mutation, there was no difference in OS compared to those with a wildtype KRAS. The median survival was almost identical at 7.5 months ( KRAS mutation, 95% CI, 3.32-11.74) and 7.0 months ( KRAS wildtype, 95% CI, 3.59-10.41). Additionally, in PFS, there was no difference between the 2 groups (5.8 vs 6.3 months). Conclusions Our analysis did not show a worse prognosis in patients with a KRAS mutation or in those with missing TTF1 expression, which is most likely related to the new therapeutic options. As a result of the administration of immunotherapy in patients with a KRAS mutation and the change from a regimen containing pemetrexed to a regimen containing no pemetrexed, the corresponding patients no longer seem to have a worse prognosis.

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Section: Discussionmentioning

confidence: 88%

Retrospective Data Analysis of Patients With Metastatic Lung Adenocarcinoma With or Without KRAS-Mutation or TTF1-Expression

2022

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“…In the advanced stage, however, which included 6939 patients, 24,25 the KRAS ‐mutant group showed a poor OS compared with wild‐type counterparts. Svaton et al, 26 in a real‐world experience of 39 patients, demonstrated a shorter OS for the G12C group compared with other KRAS mutations, whereas in another study on 677 patients, Yu and Sima et al 27 demonstrated no difference in OS between the two subgroups. However, this study did not include KRAS wild‐type patients.…”

Section: Discussionmentioning

confidence: 97%

KRAS mutated Non‐Small Lung Carcinoma: A Real World Context from the Indian subcontinent

et al. 2022

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Background KRAS , although a common variant of occurrence (~20% of non‐small‐cell lung carcinoma [NSCLC]) has been untargetable, owing to the molecular structure which inherently prevents drug binding. KRAS mutations in NSCLC are associated with distinct clinical profiles including smokers and mucinous histology. KRAS G12C mutations account for ~40% KRAS altered NSCLC, but NSCLC being a geographically diverse disease, the features may be distinct in this part of the world. This is a single‐center experience of KRAS ‐mutated NSCLC including clinical, imaging, pathologic features, and treatment patterns and outcomes. Methods This is a single‐center retrospective study of KRAS‐mutated NSCLC. The clinicopathological features and outcomes were retrieved and collated from the medical record archives of the hospital. Results Fifty (30.6%) patients with advanced‐stage NSCLC with alterations in the KRAS gene were enrolled in the 163 patients who were tested for KRAS alterations. The median age was 61 years. Molecular detection revealed three main types of KRAS mutations viz‐a‐vis: G12C in 17 (34%), G12V in 9 (18%), and G12D in 6 (12%) patients. Comparing G12C versus the non‐G12C mutated cases, co‐mutations were common in the non‐G12C subgroup ( p < 0.05). Among the 36, who were treated at our center, all received chemotherapy as the first line with a median progression‐free survival (PFS)of 5.4 months. The PFS of G12C was higher than the non‐G12C subgroup (6.4 vs 3.8 months). Conclusion This is the largest single‐center experience from the Indian subcontinent for KRAS‐mutated NSCLC with distinct clinical features. It highlights the unmet need for G12C inhibitors in our country, where prevalence is equivalent to the West.

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“…NSCLC has its specific oncomarkers, including cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA) for lung adenocarcinomas [9]. These markers, too, possess prognostic and perhaps some predictive potential in NSCLC, as reported from previous studies mainly in patients treated with chemotherapy [10][11][12].…”

Section: Ivyspring International Publishermentioning

confidence: 91%

Circulating Tumor DNA correlates with Lactate Dehydrogenase, CYFRA 21-1, and CRP levels in patients with advanced NSCLC

et al. 2023

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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.

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Prognostic Role for CYFRA 21-1 in Patients With Advanced-stage NSCLC Treated With Bevacizumab Plus Chemotherapy

Cited by 8 publications

References 0 publications

Retrospective Data Analysis of Patients With Metastatic Lung Adenocarcinoma With or Without KRAS-Mutation or TTF1-Expression

Retrospective Data Analysis of Patients With Metastatic Lung Adenocarcinoma With or Without KRAS-Mutation or TTF1-Expression

KRAS mutated Non‐Small Lung Carcinoma: A Real World Context from the Indian subcontinent

Circulating Tumor DNA correlates with Lactate Dehydrogenase, CYFRA 21-1, and CRP levels in patients with advanced NSCLC

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