Serum Tumor Marker Dynamics as Predictive Biomarkers in NSCLC Chemo-Immunotherapy and Mono-Immunotherapy Maintenance: A Registry-Based Descriptive Study

• Published in: Lung cancer (Auckland) 2020-01, Vol.11, p.113-121
• Main Authors: Lang, David, Haslinger, Wolfgang, Akbari, Kaveh, Scala, Mario, Hergan, Benedikt, Asel, Christian, Horner, Andreas, Wass, Romana, Brehm, Elmar, Kaiser, Bernhard, Lamprecht, Bernd
• Format: Article
• Language: English
• Subjects: Antigens; Biological markers; Biomarkers; Cancer; Cancer therapies; Carcinoembryonic antigen; Care and treatment; CEA (Oncology); Chemotherapy; Computed tomography; cyfra 21-1; Cytokeratin; Diagnosis; Immune checkpoint inhibitors; Immunoassay; Immunotherapy; Keratin; Lung cancer; Lung cancer, Non-small cell; Monoclonal antibodies; nivolumab; Non-small cell lung carcinoma; Original Research; Patients; PD-1 protein; PD-L1 protein; pembrolizumab; Pharmaceutical industry; Phosphopyruvate hydratase; Platinum; platinum doublet chemotherapy; recist; Small cell lung carcinoma; Solid tumors; Targeted cancer therapy; Tumor markers; Tumors
• ISSN: 1179-2728; 1179-2728
• DOI: 10.2147/LCTT.S286228

To evaluate serum tumor markers (STM) as predictive biomarkers in advanced non-small cell lung cancer (NSCLC) treated with chemo-immunotherapy. Patients having received platinum-based chemo-(CHT) and PD-1/PD-L1-directed immune checkpoint inhibitor (ICI) combination therapy were retrospectively followed. Carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), cytokeratin-19 fragments (CYFRA 21-1) and neuron specific enolase (NSE) were routinely measured at NSCLC diagnosis. The marker with the highest relative elevation was defined "leading STM", its change was assessed between CHT-ICI as well as mono-ICI maintenance initiation and the respective subsequent restaging. Corresponding computed tomography evaluations were analyzed using response evaluation criteria in solid tumors (RECIST). For CHT-ICI combination and subsequent mono-ICI-maintenance therapy, leading STM and RECIST response were evaluated regarding progression-free (PFS) and overall survival (OS) in Kaplan-Meier analyses. Among 80 CHT-ICI patients (41% women, mean age 63 years), median PFS was 5 months (M;4,9), median OS was 15M (10,/). PFS was significantly (p=0.042) longer, when the leading STM had decreased at first restaging under CHT-ICI combination therapy (9M (5,12; n=41) vs 5M (3,6; n=16)). In the 54 (67.5%) patients who received subsequent mono-ICI maintenance therapy, STM decrease was similarly associated with significantly (p