中国肺癌杂志2017，Vol.20Issue(9)：589-597,9.DOI:10.3779/j.issn.1009-3419.2017.09.01
血清肿瘤标志物与一线EGFR-TKIs治疗晚期EGFR突变型肺腺癌患者疗效相关性分析
Correlation between Serum Tumor Markers and Efficacy of First-line EGFR-TKIs in Patients with Advanced Lung Adenocarcinoma
摘要
Abstract
Background and objective Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs)significantly improve the survival of advanced lung adenocarcinoma patients harboring EGFR mutation.Limited to the standards of tumor tissue samples and detection methods,still some people can't receive target therapy following genetic guidance.This study was to explore the relevance between serum tumor markers and treatment of EGFR-TKIs.Methods We retrospectively collected the clinical information of advanced lung adenocarcinoma patients harboring EGFR mutation,who received EGFR-TKIs as first-line therapy from June 2009 to June 2014 in Peking University Cancer Hospital,analyzed the relationship between serum tumor markers and efficacy of EGFR-TKIs.Results The objective response rate (ORR)was 52.8％ and the disease control rate (DCR) was 89.3％.The results showed that,patients with high CEA level before treatment responded better to TKIs (ORR 61.3％ vs 35.9％,DCR 95.2％ vs 74.4％,P＜0.001).Similar phenomena was found in patients with CEA decreased 1 month later (61.5％ vs 25％,P=0.002).Progression-free survival (PFS) significantly prolonged in patients with elevated baseline CEA (mPFS 9.8 mo vs 5.9 mo,P=0.027).To the opposite,PFS was significantly shorter in patients with elevated baseline CYFRA21-1 and CA125 (mPFS 9.0 mo vs 11.4 mo,P=0.029;9.0 mo vs 11.5 mo,P=0.023,respectively).Multivariate analysis showed that Eastern Cooperative Oncology Group (ECOG) score of 0-1,normal baseline CYFRA21-1 and CEA decline predicted longer PFS.The overall survival (OS) was highly associated with elevated CYFRA21-1 and CA125 (median OS 25.1 mo vs 52.5 mo,P=0.003;22.7 mo vs 55.0 mo,P＜0.001,respectively),while independent of CEA.Conclusion High level of baseline CEA and decline 1 month after treatment could predict the efficacy of EGFR-TKIs in patients with advanced lung adenocarcinoma.While high levels of baseline CYFRA21-1 and CA125 indicated shortened survival.关键词
外周血肿瘤标志物/肺肿瘤/EGFR酪氨酸激酶抑制剂/疗效/生存Key words
Serum tumor markers/Lung neoplasms/EGFR-TKIs/Efficacy/Survival引用本文复制引用
陈含笑,安彤同,吴梅娜,王子平,赵军,杨雪,刘慧君,马琨,仲佳,董智,卓明磊,王玉艳,李俭杰..血清肿瘤标志物与一线EGFR-TKIs治疗晚期EGFR突变型肺腺癌患者疗效相关性分析[J].中国肺癌杂志,2017,20(9):589-597,9.基金项目
本研究受国家自然科学基金青年科学基金(No.81401914)、北京市医院管理局青年人才培养“青苗”计划(No.QMS 20161112)和吴阶平医学基金会临床科研专项资助基金(No.320.6750.1361)资助 This study was supported by the grants from National Natural Sciences Foundation for Young Scholars of China (No.81401914),Beijing Municipal Administration of Hospitals' Young Scholar Program (No.QMS 20161112) and Wu Jieping Medical Foundation Special Fund for Clinical Research (No.320.6750.1361) (to Yuyan WANG). （No.81401914）
