Serum carcinoembryonic antigen level is associated with epidermal growth factor receptor mutations in recurrent lung adenocarcinomas

Fukushima, Shoji; Yoshino, Ichiro; Yano, Tokujiro; Kometani, Takuro; Ohba, Taro; Kouso, Hidenori; Takenaka, Tomoyoshi; Miura, Naruhisa; Okazaki, Hiroshi; Maehara, Yoshihiko

doi:10.1002/cncr.23101

Cited by 34 publications

(36 citation statements)

References 30 publications

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“…Both the univariate and multivariate analyses indicated that the serum CEA levels correlated with EGFR mutations (higher serum CEA levels were associated with higher EGFR gene mutation rates). Our data are similar to the findings of Okamato et al [34]. Shoji et al [35] reported that the rate of EGFR gene mutation significantly increased as the serum CEA levels increased (for serum CEA levels <5, ≥5 (but <20), and ≥20, the rates of EGFR gene mutation were 35, 55 and 87.5%, respectively; p = 0.040).…”

Section: Discussionsupporting

confidence: 91%

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

Gao

Song

et al. 2017

BMC Cancer

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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.

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Section: Discussionsupporting

confidence: 91%

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

Gao

Song

et al. 2017

BMC Cancer

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“…Our data are similar to the data of Okamato et al (11). Shoji et al (22) reported that the rate of the EGFR gene mutation significantly increased as the serum CEA level increased (for serum CEA levels of <5, ≥5 but <20, and ≥20, the rate of the EGFR gene mutation was 35, 55 and 87.5%, respectively; P=0.040). However, our data showed that the status of the EGFR mutation made no difference in the CEA levels.…”

Section: Discussionsupporting

confidence: 91%

Prognostic and predictive value of CEA and CYFRA 21-1 levels in advanced non-small cell lung cancer patients treated with gefitinib or erlotinib

Jung

Kim

Lee

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The prognostic and predictive value of pre-treatment serum levels of carcinoembryonic antigen (CEA) and cytokeratin-19 fragments (CYFRA 21-1) were assessed in advanced non-small cell lung cancer (NSCLC) patients treated with gefitinib or erlotinib. Pre-treatment CEA and CYFRA 21-1 levels were measured in 123 advanced NSCLC patients receiving gefitinib or erlotinib. High CEA levels (h-CEA) were significantly associated with females, patients with adenocarcinoma and non-smokers. Low CYFRA 21-1 levels (l-CYFRA 21-1) were significantly associated with a good performance status (ECOG PS 0-

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“…On the other hand, Okamoto et al (24) and Jung et al (23) reported that patients treated with EGFR-TKI with higher CEA levels had a longer survival and a better response than those with low CEA levels. Shoji et al (36) reported that the rate of EGFR gene mutation is significantly increased as the levels of CEA increases (for the levels of CEA of <5, ≥5 but <20 and ≥20 the rate of EGFR gene mutation was 35, 55 and 87.5%, respectively; P=0.040). Their study presented a significant association between EGFR gene mutations and the levels of CEA in patients with lung adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

The level of serum carcinoembryonic antigen is a surrogate marker for the efficacy of EGFR-TKIs but is not an indication of acquired resistance to EGFR-TKIs in NSCLC patients with EGFR mutationsm

Han

Cao

et al. 2017

Biomedical Reports

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Abstract. The aim of the present study was to define the relationship between carcinoembryonic antigen (CEA) and survival in non-small cell lung cancer (NSCLC) patients receiving epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and to investigate whether the level of serum CEA is related to the mechanism for acquisition of resistance to EGFR-TKIs. A total of 100 patients with advanced NSCLC (stage IIIB or stage IV) and harboring EGFR mutations were included. All patients received erlotinib or gefitinib treatment. The correlation between CEA serum level and clinical benefit from erlotinib or gefitinib treatment was analyzed. Patients were appraised by a review of data from a prospective re-biopsy protocol for lung cancer patients with an EGFR-mutated phenotype with acquired resistance to EGFR-TKI therapy. Of 100 patients, 49 and 21 patients carried high and low level of CEA, respectively; 30 carried normal CEA. Median progression-free survival was 6.4 and 4.5 months in patients with high and low level of CEA, respectively (P= 0.027). Median PFS of patients in low-CEA group longer than that of those with normal level of tumors (3.0 months; P= 0.002). The difference between groups L and N was not significant regarding objective response rate and overall survival. No significant difference was found in three groups of acquired resistance to EGFR-TKIs. The relative CEA level could predict benefit of EGFR-TKI therapy in advanced NSCLC, but could not predict acquired resistance to EGFR-TKIs.

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Serum carcinoembryonic antigen level is associated with epidermal growth factor receptor mutations in recurrent lung adenocarcinomas

Cited by 34 publications

References 30 publications

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

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

Prognostic and predictive value of CEA and CYFRA 21-1 levels in advanced non-small cell lung cancer patients treated with gefitinib or erlotinib

The level of serum carcinoembryonic antigen is a surrogate marker for the efficacy of EGFR-TKIs but is not an indication of acquired resistance to EGFR-TKIs in NSCLC patients with EGFR mutationsm

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