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Onuki Y, Matsubara H, Koizumi R, Muto M, Sasanuma H, Sato D, Sugimura A, Uchida T, Matsuoka H, Nakajima H. Prognostic evaluation of preoperative serum tumor marker-negative cases in non-small cell lung cancer: A retrospective study. Cancer Rep (Hoboken) 2023; 6:e1696. [PMID: 36806719 PMCID: PMC9940002 DOI: 10.1002/cnr2.1696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/09/2022] [Accepted: 07/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The role of various serum tumor markers (TMs) has been reported in non-small cell lung cancer (NSCLC). However, the prognosis of patients with multiple TM-negative NSCLC remain unclear. AIMS This study aimed to describe the characteristics and outcomes of patients with NSCLC undergoing surgery and to investigate their prognostic association with preoperative serum TM-negative cases. METHODS AND RESULTS We retrospectively evaluated 442 patients who underwent complete resection of stage I NSCLC between January 2004 and December 2019. These 442 patients were classified into a group whose preoperative serum levels of carcinoembryonic antigen (CEA), cytokeratin-19 fragment (CYFRA21-1), carbohydrate antigen 19-9 (CA19-9), and squamous cell carcinoma antigen (SCC Ag) were all negative (TM-negative group; n = 249, 56%) and a group with at least one positive marker (TM-positive group; n = 193, 44%). Among all patients, the TM-negative group showed higher 5-year recurrence-free survival (RFS) (92.6% vs. 79.1%; p < .01), and overall survival (OS) rates (86.3% vs. 68.6%; p < .01). After propensity score matching, patients in the TM-negative group still exhibited good 5-year RFS (92.1% vs. 81.4%; p = .01) and OS rates (87.6% vs. 72.6%; p < .01). CONCLUSION Our study suggests that NSCLC patients who are preoperatively negative for all serum TMs, such as CEA, CYFRA21-1, CA19-9, and SCC Ag, represent a subgroup with a particularly good prognosis.
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Affiliation(s)
- Yuichiro Onuki
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Hirochika Matsubara
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Ryunosuke Koizumi
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Mamoru Muto
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Harunobu Sasanuma
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Daisuke Sato
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Aya Sugimura
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | - Tsuyoshi Uchida
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
| | | | - Hiroyuki Nakajima
- Division of General Thoracic Surgery, Department of SurgeryYamanashi UniversityYamanashiJapan
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Stirling RG, Chau C, Shareh A, Zalcberg J, Fischer BM. Effect of Follow-Up Surveillance After Curative-Intent Treatment of NSCLC on Detection of New and Recurrent Disease, Retreatment, and Survival: A Systematic Review and Meta-Analysis. J Thorac Oncol 2021; 16:784-797. [DOI: 10.1016/j.jtho.2021.01.1622] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 12/22/2020] [Accepted: 01/23/2021] [Indexed: 12/21/2022]
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Crosbie PAJ, Shah R, Summers Y, Dive C, Blackhall F. Prognostic and predictive biomarkers in early stage NSCLC: CTCs and serum/plasma markers. Transl Lung Cancer Res 2015; 2:382-97. [PMID: 25806257 DOI: 10.3978/j.issn.2218-6751.2013.09.02] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 09/27/2013] [Indexed: 12/18/2022]
Abstract
Resection of early stage non-small cell lung cancer (NSCLC) offers patients the best hope of cure, however recurrence rates post-resection remain high suggesting the presence of micro-metastatic disease at the time of surgery undetected by standard staging methods. A critical step in the metastatic cascade is the entry of tumor cells into the circulation enabling their distribution to and seeding of distant organs. This review explores the evidence for predictive and prognostic circulating biomarkers in the early stage NSCLC population. We summarize studies that have explored a variety of targets including circulating proteins, nucleic acids and more recently circulating tumor cells (CTCs) as potentially clinically relevant biomarkers in the early stage setting. Circulating biomarkers may add clinically relevant information about the biological behavior of tumors over and above that provided by pathological staging. Improvement in the stratification of patients according to the likelihood of metastatic relapse after radical treatments such as surgical resection could allow more effective targeting of systemic therapies such as adjuvant chemotherapy.
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Affiliation(s)
- Philip A J Crosbie
- North West Lung Centre, University Hospital of South Manchester NHS Foundation Trust, University of Manchester, Manchester Academic Health Science Centre, Wythenshawe, M23 9LT, UK ; ; Clinical and Experimental Pharmacology Group, Paterson Institute for Cancer Research, University of Manchester, M20 4BX, UK
| | - Rajesh Shah
- Department of Thoracic Surgery, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, M23 9LT, UK
| | - Yvonne Summers
- Pulmonary Oncology Unit, University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, M23 9LT, UK ; ; Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
| | - Caroline Dive
- Clinical and Experimental Pharmacology Group, Paterson Institute for Cancer Research, University of Manchester, M20 4BX, UK
| | - Fiona Blackhall
- Clinical and Experimental Pharmacology Group, Paterson Institute for Cancer Research, University of Manchester, M20 4BX, UK ; ; Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, M20 4BX, UK
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Colt HG, Murgu SD, Korst RJ, Slatore CG, Unger M, Quadrelli S. Follow-up and Surveillance of the Patient With Lung Cancer After Curative-Intent Therapy. Chest 2013; 143:e437S-e454S. [DOI: 10.1378/chest.12-2365] [Citation(s) in RCA: 157] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Rinewalt D, Shersher DD, Daly S, Fhied C, Basu S, Mahon B, Hong E, Chmielewski G, Liptay MJ, Borgia JA. Development of a serum biomarker panel predicting recurrence in stage I non–small cell lung cancer patients. J Thorac Cardiovasc Surg 2012; 144:1344-50; discussion 1350-1. [DOI: 10.1016/j.jtcvs.2012.08.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 08/01/2012] [Accepted: 08/14/2012] [Indexed: 12/13/2022]
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6
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Barthel BL, Rudnicki DL, Kirby TP, Colvin SM, Burkhart DJ, Koch TH. Synthesis and biological characterization of protease-activated prodrugs of doxazolidine. J Med Chem 2012; 55:6595-607. [PMID: 22742660 DOI: 10.1021/jm300714p] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Doxazolidine (doxaz) is a new anthracycline anticancer agent. While structurally similar to doxorubicin (dox), doxaz acts via a distinct mechanism to selectively enhance anticancer activity over cardiotoxicity, the most significant clinical impediment to successful anthracycline treatment. Here, we describe the synthesis and characterization of a prodrug platform designed for doxaz release mediated by secreted proteolytic activity, a common association with invasiveness and poor prognosis in cancer patients. GaFK-Doxaz is hydrolyzable by the proteases plasmin and cathepsin B, both strongly linked with cancer progression, as well as trypsin. We demonstrate that activation of GaFK-Doxaz releases highly potent doxaz that powerfully inhibits the growth of a wide variety of cancer cells (average IC(50) of 8 nM). GaFK-Doxaz is stable in human plasma and is poorly membrane permeable, thereby limiting activation to locally secreted proteolytic activity and reducing the likelihood of severe side effects.
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Affiliation(s)
- Benjamin L Barthel
- Department of Chemistry and Biochemistry, University of Colorado, Boulder, CO 80309-0215, USA
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Farlow EC, Vercillo MS, Coon JS, Basu S, Kim AW, Faber LP, Warren WH, Bonomi P, Liptay MJ, Borgia JA. A multi-analyte serum test for the detection of non-small cell lung cancer. Br J Cancer 2010; 103:1221-8. [PMID: 20859284 PMCID: PMC2967050 DOI: 10.1038/sj.bjc.6605865] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In this study, we appraised a wide assortment of biomarkers previously shown to have diagnostic or prognostic value for non-small cell lung cancer (NSCLC) with the intent of establishing a multi-analyte serum test capable of identifying patients with lung cancer. METHODS Circulating levels of 47 biomarkers were evaluated against patient cohorts consisting of 90 NSCLC and 43 non-cancer controls using commercial immunoassays. Multivariate statistical methods were used on all biomarkers achieving statistical relevance to define an optimised panel of diagnostic biomarkers for NSCLC. The resulting biomarkers were fashioned into a classification algorithm and validated against serum from a second patient cohort. RESULTS A total of 14 analytes achieved statistical relevance upon evaluation. Multivariate statistical methods then identified a panel of six biomarkers (tumour necrosis factor-α, CYFRA 21-1, interleukin-1ra, matrix metalloproteinase-2, monocyte chemotactic protein-1 and sE-selectin) as being the most efficacious for diagnosing early stage NSCLC. When tested against a second patient cohort, the panel successfully classified 75 of 88 patients. CONCLUSIONS Here, we report the development of a serum algorithm with high specificity for classifying patients with NSCLC against cohorts of various 'high-risk' individuals. A high rate of false positives was observed within the cohort in which patients had non-neoplastic lung nodules, possibly as a consequence of the inflammatory nature of these conditions.
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Affiliation(s)
- E C Farlow
- Department of General Surgery, Rush University Medical Center, 785 Jelke-Southcenter, 1750 W. Harrison Street, Chicago, IL 60612, USA
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Pisters K. Adjuvant and Neoadjuvant Therapy of NSCLC. Lung Cancer 2010. [DOI: 10.1007/978-1-60761-524-8_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Establishment of a multi-analyte serum biomarker panel to identify lymph node metastases in non-small cell lung cancer. J Thorac Oncol 2009; 4:338-47. [PMID: 19190517 DOI: 10.1097/jto.0b013e3181982abf] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION In non-small cell lung cancer (NSCLC), the presence of locoregional lymph node metastases remains the most important prognostic factor and significantly guides treatment regimens. Unfortunately, currently-available noninvasive staging modalities have limited accuracy. The objective of this study was to create a multianalyte blood test capable of discriminating a patient's true (pathologic) nodal status preoperatively. METHODS Pretreatment serum specimens collected from 107 NSCLC patients with localized disease were screened with 47 biomarkers implicated in disease presence or progression. Multivariate statistical algorithms were then used to identify the optimal combination of biomarkers for accurately discerning each patient's nodal status. RESULTS We identified 15 candidate biomarkers that met our criteria for statistical relevance in discerning a patient's preoperative nodal status. A 'random forest' classification algorithm was used with these parameters to define a 6-analyte panel, consisting of macrophage inflammatory protein-1alpha, carcinoembryonic antigen, stem cell factor, tumor necrosis factor-receptor I, interferon-gamma, and tumor necrosis factor-alpha, that was the optimum combination of biomarkers for identifying a patient's pathologic nodal status. A Classification and Regression Tree analysis was then created with this panel that was capable of correctly classifying 88% of the patients tested, relative to the pathologic assessments. This value is in contrast to our observed 85% classification rate using conventional clinical methods. CONCLUSIONS This study establishes a serum biomarker panel with efficacy in discerning preoperative nodal status. With further validation, this blood test may be useful for assessing nodal status (including occult disease) in NSCLC patients facing tumor resection therapy.
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Dziadziuszko R, Hirsch FR. Advances in genomic and proteomic studies of non-small-cell lung cancer: clinical and translational research perspective. Clin Lung Cancer 2008; 9:78-84. [PMID: 18501093 DOI: 10.3816/clc.2008.n.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Recent years have brought tremendous progress in the development of genomic and proteomic platforms to study cancer biology. Tests based on these platforms are helpful in early diagnosis, prognosis, and prediction of treatment benefit. Molecular studies performed on minimally invasive material (plasma, sputum) from individuals participating in longitudinal or case-control studies have approximately 70%-90% sensitivity and specificity to detect lung cancer. In operable non-small-cell lung cancer, genomic and proteomic studies yield better prognostic information than pathologic staging. There are several examples of successful identification of predictive assays for benefit from chemotherapy (ERCC1, RRM1, p27Kip1, and p53 expression) or targeted therapies (epidermal growth factor receptor [EGFR] gene copy number, EGFR activating mutations, EGFR protein expression, serum proteomic profile). These markers should be prospectively tested in clinical studies before they can be routinely used in the clinic.
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Affiliation(s)
- Rafal Dziadziuszko
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland.
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Petersen RP, D'Amico TA. Molecular and Genetic Markers in Thoracic Surgery. Ann Thorac Surg 2006; 82:2335-6. [PMID: 17131544 DOI: 10.1016/j.athoracsur.2006.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Rebecca P Petersen
- Albert Thoracic Oncology Program, Division of Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA
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