Serum CEA Level Change and Its Significance Before and after Gefitinib Therapy on Patients with Advanced Non-small Cell Lung Cancer

Abstract

Objective: The aim of this study was to explore change and significance of serum carcino-embryonic antigen (CEA) before and after gefitinib therapy in patients with advanced non-small-cell lung cancer (NSCLC). Methods: Forty patients with advanced NSCLCs in Ⅲ~Ⅳ stages were selected as study objects given gefitinib therapy combined with routine local radiotherapy until tumor progression or intolerable toxicity. After treatment, all patients were divided into control and non-control groups according to the results of evaluation based on RECIST 1.1 (Response Evaluation Criteria in Solid Tumors in 2009). Peripheral fasting blood from all patients was collected in the early morning and serum CEA was assessed by electro-chemiluminescence immunoassay (ECLIA) before and after treatment. Before treatment, patients were divided into high CEA group (CEA level > 50 ng/mL) and low CEA group (CEA level ≤ 50 ng/mL). Adverse reactions were noted and progression-free survival (PFS) in both groups was recorded after long-term follow-up that ended in December, 2012. Results: There was no difference between control and non-control groups in CEA level before treatment (P>0.05), whereas serum CEA decreased more markedly lower in the control group after treatment (P<0.01). All patients were divided into high CEA group (26) and low CEA group (14) according to serum CEA level. There was no statistically significant difference between two groups in adverse reactions (P>0.05) but the rate in former group was lower. Additionally, survival rates at 9 and 12 months in high CEA group were clearly higher than in the low CEA group (P<0.01). Conclusions: Serum CEA level can serve as a biochemical index to evaluate the prognosis with gefitinib treatment for NSCLC.

Correlation between Serum Carcinoembryonic Antigen Level and Histologic Subtype in Resected Lung Adenocarcinoma

“…It can also be secreted by the expression of tumor cell genes to early diagnose lung cancer (Wang et al, 2013;Wang et al, 2014a;2014b), evaluate therapeutic effect and observe the progression of disease (Qin et al, 2013). In the present study, lung adenocarcinoma patients with high serum CEA level had unfavorable prognosis in overall and p-stage I disease, in agreement with the results of previous studies (Okada et al, 2004;Sawabata et al, 2004;Tomita et al, 2004).…”

Correlation between pre‐treatment serum carcinoembryonic antigen levels and genotypes in a large population of Chinese people with advanced lung adenocarcinoma

“…In addition, they were also found to be prognostic for advanced non‐small‐cell lung cancer patients undergoing gefitinib treatment . Qin et al ’s study also found that progression‐free survival in advanced non‐small‐cell lung cancer patients treated with gefitinib who had high CEA levels was significantly higher than in patients with low CEA levels . Shoji et al have reported that serum CEA levels were correlated with EGFR gene mutations in 48 patients with a post‐operative recurrence of lung adenocarcinomas, and that the EGFR gene mutation rate significantly increased as the serum CEA levels increased ( P = 0.040) .…”

“…13 Qin et al's study also found that progressionfree survival in advanced non-small-cell lung cancer patients treated with gefitinib who had high CEA levels was significantly higher than in patients with low CEA levels. 24 Shoji et al have reported that serum CEA levels were correlated with EGFR gene mutations in 48 patients with a post-operative recurrence of lung adenocarcinomas, and that the EGFR gene mutation rate significantly increased as the serum CEA levels increased (P = 0.040). 25 Our results demonstrated that in Chinese patients with advanced lung adenocarcinoma, patients with abnormal serum CEA levels had a higher rate of occurrence of EGFR mutations.…”

Serum Carcinoembryonic Antigen Levels before Initial Treatment are Associated with EGFR Mutations and EML4-ALK Fusion Gene in Lung Adenocarcinoma Patients

“…On the contrary, Okamoto's study demonstrated patients with a serum CEA concentration of over 5 ng/ml were more sensitive :http://dx.doi.org/10.7314/APJCP.2014.15.9.3927 Pre-Treatment Serum CEA and EGFR Mutations and EML4-ALK Fusion Gene in Lung Adenocarcinoma to gefitinib treatment than those with a concentration of below 5 ng/ml (Okamoto et al, 2005). Qin's study also found that progress-free survival in high CEA group was significantly higher than in low CEA group among advanced NSCLC patients treated with gefitinib (Qin et al, 2013). It was perplexing, and they hypothesized that anti-apoptotic signal of the EGFR mutation may somehow elevate the expression level of CEA protein.…”