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Early and Specific Prediction of the Therapeutic Efficacy in Non–Small Cell Lung Cancer Patients by Nucleosomal DNA and Cytokeratin‐19 Fragments
Author(s) -
HOLDENRIEDER STEFAN,
STIEBER PETRA,
VON PAWEL JOACHIM,
RAITH HANNELORE,
NAGEL DOROTHEA,
FELDMANN KNUT,
SEIDEL DIETRICH
Publication year - 2006
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1368.033
Subject(s) - carcinoembryonic antigen , medicine , cytokeratin , lung cancer , oncology , univariate analysis , chemotherapy , enolase , pathology , cancer , immunology , multivariate analysis , cancer research , immunohistochemistry
Facing an era of promising new antitumor therapies, predictors of therapy response are needed for the individual management of treatment. In sera collected prospectively from 311 patients with advanced non‐small cell lung cancer receiving first‐line chemotherapy, changes in nucleosomal DNA fragments, cytokeratin‐19 fragments (CYFRA 21–1), carcinoembryonic antigen (CEA), neuron‐specific enolase (NSE), and progastrin‐releasing peptide (ProGRP) were investigated and correlated with therapy response. In univariate analysis, high levels, slower and incomplete decline in nucleosomal DNA, CYFRA 21–1, and CEA predicted poor outcome. DNA concentrations at day 8 of the first therapeutic cycle and CYFRA 21–1 before start of the second cycle were identified as best predictive variables. In multivariate analysis, they predicted progression with a specificity of 100% in 29% of the cases earlier than imaging techniques. Thus, nucleosomal DNA and CYFRA 21–1 specifically identify a subgroup of patients with insufficient therapy response at the early treatment phase and showed to be valuable for disease management.