Elevated serum CEA levels are associated with the explosive progression of lung adenocarcinoma harboring EGFR mutations

Abstract

BackgroundSerum carcinoembryonic antigen (CEA) levels are a predictor of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) efficacy and are associated with epidermal growth factor receptor (EGFR) gene mutations. However, the clinical significance of plasma CEA level changes during different cycles of target therapy is unknown for lung adenocarcinoma patients with sensitizing EGFR mutations.MethodsIn total, 155 patients with lung adenocarcinoma were enrolled in this retrospective study between 2011 and 2015. EGFR mutations were detected by RT-PCR (real-time quantitative PCR). Plasma CEA levels were measured prior to different EGFR-TKI treatment cycles. Computed tomography (CT) scans were conducted every 2 months to assess the therapeutic efficacy.ResultsSerum CEA concentrations were significantly associated with EGFR mutations (p < 0.05). Furthermore, in all patients treated with EGFR-TKIs, the serum CEA levels increased with disease progression (p < 0.005). A COX multivariate analysis revealed that CEA levels 16.2 times above normal were associated with early disease progression (HR, 5.77; 95% CI:2.36 ~ 14.11; p < 0.001). Based on this finding, a threshold was set at the median time of 8.3 months. Patients with EGFR mutations exhibited a median progression-free survival time of 12.8 months. Serum CEA levels were markedly increased compared to levels measured 4.5 months prior to the changes detected via CT scans for patients resistant to EGFR-TKIs.ConclusionsElevated CEA levels during targeted therapy may be a more sensitive predictor of explosive lung adenocarcinoma progression in patients harboring mutant EGFRs compared to traditional imaging methods.

Development and validation of a model to predict tyrosine kinase inhibitor‐sensitive EGFR mutations of non‐small cell lung cancer based on multi‐institutional data

“…Several recent studies have assessed their value for predicting EGFR mutation status and the therapeutic effects of TKIs. The serum CEA level in Chinese patients is not only positively associated with EGFR mutation, but also negatively associated with the efficacy of TKI therapy . Although data on Chinese patients is lacking, studies performed in other Asian countries have shown that serum Cyfra 21‐1 level was associated with EGFR mutation and tumor response to TKIs .…”

“…The serum CEA level in Chinese patients is not only positively associated with EGFR mutation, but also negatively associated with the efficacy of TKI therapy. 24,25 Although data on Chinese patients is lacking, studies performed in other Asian countries have shown that serum Cyfra 21-1 level was associated with EGFR mutation and tumor response to TKIs. 26,27 Our study indicated that patients with low Cyfra 21-1 (< 3.3 ng/mL) were more likely to harbor del19 or L858R mutations.…”

Prognostic significance of NDRG2 combined with EGFR patients with lung adenocarcinoma

“…CEA was first described in 1965 by Gold and Freedman as an antigen present in gastrointestinal carcinoma cells [14,21]. A number of researches demonstrated the prognostic value of preoperative CEA levels as a classical marker for LUAD [22,23].…”

Prognostic significance of NDRG2 combined with EGFR patients with lung adenocarcinoma

“…CEA was first described in 1965 by Gold and Freedman as an antigen present in gastrointestinal carcinoma cells [14,19]. A number of researches demonstrated the prognostic value of the preoperative CEA level, as a classical marker for LUAD [20,21].…”