Baseline and On-Treatment Characteristics of Serum Tumor Markers in Stage IV Oncogene-Addicted Adenocarcinoma of the Lung.

Autor:	Noonan SA; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Patil T; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Gao D; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado., King GG; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Thibault JR; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Lu X; Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado., Bunn PA; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Doebele RC; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Purcell WT; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado., Barón AE; Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado., Camidge DR; Division of Medical Oncology, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado. Electronic address: ross.camidge@ucdenver.edu.
Jazyk:	angličtina
Zdroj:	Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2018 Jan; Vol. 13 (1), pp. 134-138. Date of Electronic Publication: 2017 Aug 24.
DOI:	10.1016/j.jtho.2017.08.005
Abstrakt:	Introduction: The role of serum tumor markers in the modern management of advanced NSCLC remains poorly described. Methods: A single-center retrospective analysis of available carcinoembryonic antigen, CA125, CA19.9, and CA27.29 levels at baseline and during treatment of stage IV lung adenocarcinoma by oncogenic driver was conducted. Results: A total of 142 patients were analyzed (60 with anaplastic lymphoma kinase gene [ALK] rearrangement, 50 with EGFR mutation, four with ROS1 rearrangement, and 29 with KRAS mutation). Of these, 82% had at least one marker (95% if all four markers were measured), with CA27.29 being the most commonly increased and CA19.9 the rarest. Only CA27.29 differed significantly by oncogene (it was less common in KRAS) (p = 0.016). The median times to nadir during tyrosine kinase inhibitor (TKI) therapy in EGFR and ALK cases were 16.4 and 20 weeks, respectively. Of the 41 patients with EGFR mutation or ALK or ROS1 rearrangement, 24 (59%) demonstrated an initial increase within the first 4 weeks of TKI therapy, 58% of whom then had their levels fall below baseline. An increase in marker level of 10% or more from nadir occurred in 53% of systemic and 22% of central nervous system-only progression. Conclusions: Serum tumor markers are frequently increased in lung adenocarcinoma regardless of driver oncogene. Changes within the first 4 weeks of therapy may be misleading. Progression is associated with marker increases, especially in sites other than the central nervous system. (Copyright © 2017 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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