High serum level of C-reactive protein is associated with worse outcome of patients with advanced-stage NSCLC treated with erlotinib
High serum level of C-reactive protein is associated with worse outcome of patients with advanced-stage NSCLC treated with erlotinib
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DOI：
10.1007/s13277-015-3660-3
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发表时间：
2015-12-01
期刊：
影响因子：
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通讯作者：
Buchler, Tomas
中科院分区：
文献类型：
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作者：
Fiala, Ondrej;Pesek, Milos;Buchler, Tomas
厄洛替尼是一种针对表皮生长因子受体（EGFR）的低分子量酪氨酸激酶抑制剂（TKI），广泛用于治疗局部晚期或转移期非小细胞肺癌（NSCLC）。尽管EGFR-TKIs的引入显着延长了晚期NSCLC患者的生存期，但其在整个患者群体中的疗效相对较低。除了激活 EGFR 突变外，尚未建立对厄洛替尼反应的可靠生化或分子预测因子。我们回顾性研究的目的是评估 C 反应蛋白 (CRP) 基线血清水平与接受厄洛替尼治疗的晚期 NSCLC 患者的预后之间的关系。我们回顾性分析了 595 例接受厄洛替尼治疗的晚期 NSCLC（IIIB 或 IV）患者的临床数据。使用免疫比浊法测定血清CRP。 387 名 (65%) 患者的 CRP 基线水平较高（千分之一 10 毫克/升），208 名 (35%) 患者的 CRP 水平正常（< 10 毫克/升）。高 CRP 患者的中位无进展生存期 (PFS) 和总生存期 (OS) 分别为 1.8 和 7.7 个月，而低 CRP 患者的中位无进展生存期 (PFS) 和总生存期 (OS) 分别为 2.8 和 14.4 个月 (p < 0.001 和 p < 0.001)。多变量 Cox 比例风险模型显示，CRP 与 PFS 和 OS 显着相关（风险比 (HR) = 1.57，p < 0.001，HR = 1.63，p < 0.001）。总之，回顾性研究的结果表明，高基线 CRP 水平与接受厄洛替尼治疗的晚期 NSCLC 患者较差的预后独立相关。 CRP是常用的生物标志物，其简单易检测，在临床常规应用中是可行的。
Erlotinib is a low molecular weight tyrosine kinase inhibitor (TKI) directed at epidermal growth factor receptor (EGFR), widely used in the treatment of locally advanced or metastatic-stage non-small cell lung cancer (NSCLC). Although introduction of EGFR-TKIs have significantly extended survival of advanced-stage NSCLC patients, their efficacy in the entire patient population is relatively low. Aside from activating EGFR mutations, no reliable biochemical or molecular predictors of response to erlotinib have been established. The aim of our retrospective study was to evaluate the association of baseline serum levels of C-reactive protein (CRP) with outcomes in patients with advanced-stage NSCLC treated with erlotinib. We retrospectively analyzed clinical data of 595 patients with advanced-stage NSCLC (IIIB or IV) treated with erlotinib. Serum CRP was measured using an immunoturbidimetric method. High baseline levels of CRP (a parts per thousand yen10 mg/l) were measured in 387 (65 %) patients, and normal levels (< 10 mg/l) were measured in 208 (35 %) patients. The median progression-free survival (PFS) and overall survival (OS) for patients with high CRP was 1.8 and 7.7 compared to 2.8 and 14.4 months for patients with low CRP (p < 0.001 and p < 0.001). The multivariable Cox proportional hazards model revealed that CRP was significantly associated with PFS and also with OS (hazard ratio (HR) = 1.57, p < 0.001, and HR = 1.63, p < 0.001, respectively). In conclusion, the results of the conducted retrospective study suggest that high baseline level of CRP was independently associated with worse outcome of patients with advanced-stage NSCLC treated with erlotinib. CRP is a commonly used biomarker which is simple and easy to detect, and thus, it is feasible for the use in the routine clinical practice.