Correlation of apolipoprotein A-I kinetics with survival and response to first-line platinum-based chemotherapy in advanced non-small cell lung cancer

Abstract

The aim of this study was to determine whether apolipoprotein A-I (ApoA-I) kinetics predict the overall survival in patients with advanced-stage non-small cell lung cancer (NSCLC) during platinum-based first-line therapy. A total of 125 NSCLC patients from January 2008 to September 2014 were retrospectively reviewed. Serum ApoA-I level was measured at baseline and thereafter at the start of each palliative chemotherapy cycle for all patients. Patients were divided into four groups according to ApoA-I kinetics. Patients whose ApoA-I ≥ 1.01 g/L and never decreased during treatment, patients whose ApoA-I ≥ 1.01 g/L and decreased (ApoA-I < 1.01 g/L) at least one time during treatment, patients whose ApoA-I < 1.01 g/L and normalized (ApoA-I ≥ 1.01) at least one time during treatment, and patients whose ApoA-I < 1.01 g/L and never normalized during treatment were assigned to non-decreased, decreased, normalized, and non-normalized ApoA-I groups, respectively. Overall survival rates were significantly different between the four groups, with 2-year survival rates of 88.6 and 17.5 % for the non-decreased and the decreased ApoA-I groups, respectively, and none survived 2 years later in the normalized and the non-normalized ApoA-I groups. When compared with the non-decreased group, the hazard ratios of death were 0.05, 0.44, and 1.73 in the normalized, decreased, and non-normalized groups, respectively (P < 0.001). Normalization of ApoA-I was associated with a low risk of progression, whereas patients with a decreased level of ApoA-I showed a progression of disease in most cases. ApoA-I can be a novel, widely available biomarker for patients with NSCLC.

Emerging Roles of Apolipoprotein E and Apolipoprotein A-I in the Pathogenesis and Treatment of Lung Disease

“…Patients with advanced stage non-small cell lung cancer and persistently high serum apoA-I levels had the highest overall median survival at 36 months, whereas patients with persistently low serum apoA-I levels had the lowest median overall survival. This suggests that higher serum apoA-I levels were associated with a lower rate of disease progression in non-small cell lung cancer (91). In contrast, serum levels of pro-apoA-I have been found to be specifically and selectively increased only in patients with lung cancer that had metastasized to the brain (92).…”

Impact of Serum Apolipoprotein A-I on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer: a Propensity Score-Matched Analysis

“…The level of ApoA-I for prognosis in a range of malignancies has been previously investigated and has demonstrated an inverse relationship between the ApoA-I level and the length of survival time in ovarian cancer, lung cancer, and metastatic nasopharyngeal carcinoma [8], [9], [10]. To the best of our knowledge, this retrospective study is the first to describe the impact of the ApoA-I level on the survival of patients with mCRC.…”

“…ApoA-I has been identified as a potentially useful biomarker for effectively distinguishing cholangiocarcinoma from benign biliary disease and improving the early diagnosis of ovarian cancer [7], [8]. Moreover, decreased serum ApoA-I has been shown to be correlated with worse overall survival in lung cancer and metastatic nasopharyngeal carcinoma [9], [10]. The role of ApoA-I in patients with mCRC has not yet been reported.…”

Prognostic value of the serum apolipoprotein B to apolipoprotein A-I ratio in metastatic colorectal cancer patients

“…A recent retrospective study reported that low serum ApoA-I levels were associated with advanced T class and TNM stage and systemic inflammation biomarkers in CRC. All of these findings indicate that serum ApoA-I may participate in multiple processes in the occurrence and development of cancers [19,20,[29][30][31].…”