Zhang Nasha, Kong Li, Shi Fang, Jing Wang, Wang Haiyong, Yang Ming, Yu Jinming, Zhu Hui
Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China.
Oncotarget. 2017 Aug 24;8(43):74910-74916. doi: 10.18632/oncotarget.20456. eCollection 2017 Sep 26.
In this retrospective study, we investigated whether the kinetic change of serum carcinoembryonic antigen (CEA) levels can be an early indicator for the progression in metastatic non-small cell lung cancer (NSCLC) patients during maintenance therapy with bevacizumab plus pemetrexed. Ten patients diagnosed with metastatic lung adenocarcinoma who received a first-line therapy including bevacizumab-based chemotherapy and a following maintenance therapy including bevacizumab plus pemetrexed from June 2015 to October 2016 were recruited in this study. During the maintenance treatment, patients' CEA levels all elevated at or after the first cycle of maintenance treatment with a median CEA elevation-free survival time as 17.7 days, which was far more shorter than the median progression-free survival time evaluated by CT imaging specially for maintenance treatment (102.2 days). Before the disease progressed, the values of CEA increased steadily for several cycles with the response evaluation still as stable disease, indicating that the changes of CEA level would be earlier and more sensitive for detection of progression. The CEA kinetic was calculated with a mean of 9.6451 and a median of 8.0135, which sensitively reflected the increasing rate of CEA levels at an early stage. Our study showed that the kinetic change of CEA could be an early predictor for the progression in metastatic NSCLC patients during maintenance therapy.
在这项回顾性研究中，我们调查了血清癌胚抗原（CEA）水平的动力学变化是否可作为转移性非小细胞肺癌（NSCLC）患者在接受贝伐单抗联合培美曲塞维持治疗期间病情进展的早期指标。本研究纳入了10例在2015年6月至2016年10月期间被诊断为转移性肺腺癌且接受了包括以贝伐单抗为基础的化疗的一线治疗以及随后包括贝伐单抗联合培美曲塞的维持治疗的患者。在维持治疗期间，所有患者的CEA水平在维持治疗的第一个周期或之后均升高，CEA无升高生存期的中位数为17.7天，这远短于专门针对维持治疗通过CT成像评估的无进展生存期的中位数（102.2天）。在疾病进展之前，CEA值在几个周期内稳步升高，而疗效评估仍为疾病稳定，这表明CEA水平的变化对于检测疾病进展会更早且更敏感。计算得出的CEA动力学平均值为9.6451，中位数为8.0135，其敏感地反映了早期CEA水平的升高速率。我们的研究表明，CEA的动力学变化可能是转移性NSCLC患者在维持治疗期间病情进展的早期预测指标。
