Tumour markers for prediction of survival and monitoring of remission in small cell lung cancer

ABSTRACT Levels of the tumour markers neurone specific enolase (NSE), lactate dehydrogenase (LDH), chromogranin A (ChrA) and carcinoembryonic antigen (CEA) were measured in serum taken at

presentation and during treatment, remission and relapse from 154 patients who received chemotherapy for small cell lung cancer at a single centre over a 6 year period. At presentation NSE

was the most frequently elevated marker, being raised in 81% of patients and significantly higher in extensive as opposed to limited disease, as were LDH and ChrA. The response rate to

therapy was best correlated with presentation level of ChrA, being 79% for those whose levels were within twice the upper limit of normal and 51% above (P < 0.01). Multivariate regression

analysis showed NSE, performance status and albumin at presentation to be the best independent predictors of survival. Patients with NSE below twice the upper limit of normal, Karnofsky

performance status of 80 or above and albumin 35 g l-1 or above had a median survival of 15 months with 25% alive at 2 years, whilst those with NSE above twice normal, Karnofsky below 80 and

albumin less that 35 g l-1 had all died by 8 months. Changes in marker levels during therapy were of low predictive value for outcome although the finding of rising NSE during chemotherapy

after an initial fall correlated with significantly reduced duration of remission. There was a strong inverse correlation between the NSE level at the time of response and duration of

remission (P < 0.0001). Prediction of relapse was most reliable with ChrA, 52% of patients having rising levels before clinical evidence of disease recurrence. Access through your

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DETECTION AND PROGNOSIS OF NON-SMALL CELL LUNG CANCER Article Open access 16 July 2021 AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * ICRF Department of Medical Oncology, St

Bartholomew's Hospital, London, UK PWM Johnson Authors * PWM Johnson View author publications You can also search for this author inPubMed Google Scholar * SP Joel View author

publications You can also search for this author inPubMed Google Scholar * S Love View author publications You can also search for this author inPubMed Google Scholar * M Butcher View author

publications You can also search for this author inPubMed Google Scholar * MR Pandian View author publications You can also search for this author inPubMed Google Scholar * L Squires View

author publications You can also search for this author inPubMed Google Scholar * PFM Wrigley View author publications You can also search for this author inPubMed Google Scholar * ML Slevin

View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Johnson, P., Joel,

S., Love, S. _et al._ Tumour markers for prediction of survival and monitoring of remission in small cell lung cancer. _Br J Cancer_ 67, 760–766 (1993). https://doi.org/10.1038/bjc.1993.138

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