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Serum Neuron-Specific Enolase Levels Predict the Efficacy of First-Line Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors in Patients With Non-Small Cell Lung Cancer Harboring EGFR Mutations

Cited 10 time in Web of Science Cited 10 time in Scopus
Authors
Suh, Koung Jin; Keam, Bhumsuk; Kim, Miso; Park, Young Sik; Kim, Tae Min; Jeon, Yoon Kyung; Kim, Dong-Wan; Chung, Doo Hyun; Kim, Young Whan; Heo, Dae Seog
Issue Date
2016-07
Citation
Clinical Lung Cancer, Vol.17 No.4, pp.245-252.e1
Keywords
NSEPredictive valuePrognosisProgression-free survivalTumor heterogeneity
Abstract
Our study aimed to determine the role of serum neuron-specific enolase (NSE) in predicting epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) response in EGFR mutant non-small cell lung cancer (NSCLC). Patients with elevated serum NSE levels had significantly shorter progression-free survival (PFS) and overall survival (OS) after first-line EGFR TKI treatment. Our study suggests potential use of NSE for predicting EGFR TKI response and prognosis. Objectives: Our study aimed to determine the predictive and prognostic values of the serum neuron-specific enolase (NSE) level in patients who had non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations and who had been treated with EGFR-tyrosine kinase inhibitors (TKIs). Materials and Methods: We retrospectively analyzed 151 patients who had NSCLC harboring EGFR mutations and had received either gefitinib or erlotinib as first-line treatment between 2005 and 2014. The serum NSE level was measured before initiation of EGFR-TKI treatment. Results: Of the 151 patients, 92 (60.9%) had elevated NSE levels (> 16.3 ng/mL). Patients with elevated NSE levels showed significantly shorter progression-free survival (PFS) after EGFR-TKI treatment than those with normal NSE levels (median PFS, 10.5 months vs. 15.4 months; P = .034). Multivariate analysis demonstrated that elevated NSE levels (hazard ratio [HR], 1.656; P = .017), CNS metastasis at diagnosis (HR, 1.567; P = .037), and male gender (HR, 1.840; P = .005) were independent predictive factors for short PFS. A significant difference in overall survival (OS) was observed between patient groups with elevated and normal NSE levels (median OS, 17.0 months vs. 29.1 months; P < .001), and serum NSE level remained an independent prognostic factor for OS in multivariate analysis (HR, 2.671; P < .001). Conclusion: Patients with elevated serum NSE levels have significantly shorter PFS and OS. The NSE level is both a predictive marker of EGFR-TKI treatment and a prognostic marker in EGFR-mutant NSCLC patients. (C) 2015 Elsevier Inc. All rights reserved.
ISSN
1525-7304
URI
https://hdl.handle.net/10371/165286
DOI
https://doi.org/10.1016/j.cllc.2015.11.012
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College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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