Lack of utility of plasma TNF-alpha level in predicting therapeutic efficacy in patients with advanced non-small cell lung cancer.

BACKGROUND

Accumulating evidence suggests a change in cytokine profile after cytotoxic therapies. We hypothesized that change in plasma levels of tumor necrosis factor-alpha (TNF-alpha) during the course of chemotherapy in lung cancer may predict therapeutic efficacy at an early stage.

METHODS

Plasma TNF-alpha levels were quantified before first, second, and third cycle of chemotherapy in 42 patients with advanced non-small cell lung cancer and correlated with response to therapy as assessed by computed tomography after the third chemotherapy cycle.

RESULTS

Plasma levels of TNF-alpha measured before various treatment cycles could not differentiate among patients with remission, no change, and progression. For predicting inadequate therapeutic response, a sensitivity of 11.5% and 23.1% was achieved at 100% specificity using plasma TNF-alpha levels measured before first and second therapy cycle, respectively. Prediction of disease progression was achieved with a sensitivity of 14.3% at 100% specificity for plasma TNF-alpha levels measured before second therapy cycle. Plasma levels of TNF-alpha measured before various treatment cycles was not correlated with survival.

CONCLUSIONS

Measurement of plasma TNF-alpha may not prove to be a good biomarker for predicting therapeutic efficacy at an early stage in NSCLC. Additional, more specific, and more sensitive blood-based biomarkers will be required to further improve the diagnostic power of current imaging tools for indicating early therapeutic efficacy.