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Kashif Iqbal

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    P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.01-44 - CYFRA 21-1 As a Predictor to Response to Chemotherapy and Overall Survival in Patients with Advanced NSCLC (ID 13827)

      12:00 - 13:30  |  Presenting Author(s): Kashif Iqbal

      • Abstract


      In era of ever evolving, promising new therapies for advanced NSCLC, early predictors of response are needed. We evaluated early variations in serum CYFRA 21-1 of patients with advanced NSCLC receiving first line chemotherapy and correlated the results with objective tumor response and overall survival.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      29 consecutive untreated patients of advanced NSCLC with measurable disease on CTscan were evaluated. All patients were treated with conventional systemic chemotherapy. Serum samples were obtained before start of 1st and 2nd cycles. CYFRA 21-1 was measured with an electrochemiluminescense immunoassay. All patients were followed for a period of five years. Response was evaluated using RECIST.

      4c3880bb027f159e801041b1021e88e8 Result

      10 patients had partial response, 9 had stable disease and 9 had progression. None had complete response. 21/29 patients had elevated baseline value of CYFRA. 18/29 patients had decrease in CYFRA 21-1 after 1 cycle of chemotherapy. The average reduction in 2nd reading was irrespective of baseline value being normal or not. The average reduction was statistically significant (P = 0.002). 8/10 patients with partial response had reduction in their 2nd reading which was significant. We observed that 6/9 patients whose disease remained stable had a decrease in their subsequent reading (P=0.0106), though was not significant statistically. 5/9 patients who had an increase in their 2nd reading had progression, it was not statistically significant (P= 0.537). 14/19 who had partial response or stable disease, had a reduction in their 2nd value of CYFRA 21-1 and was significant statistically (P 0.004). We observed that except for 1, all patients who had decrease of 42% or more were responders (P 0.001), which was statistically significant.We followed all patients for five years. None was alive at 5 years. 10 patients were alive at 3 years and 6 were alive at 4 years. All patients who progressed after chemotherapy died within 1 year. 7/10 and 4/6 patients had reduction in their CYFRA 21-1 but was not statistically significant (P 0.24 95%CI -9.7-15.7). We observed that 3/4 patients who were alive at 4 years had a decrease of 30% or more in their subsequent CYFRA 21-1 level.

      8eea62084ca7e541d918e823422bd82e Conclusion

      We conclude that monitoring CYFRA 21-1 early during first-line chemotherapy may be useful prognostic tool for evaluation of early tumor response in patients with advanced NSCLC. Although decrease in CYFRA 21-1 was non statistically significant for monitoring overall survival, it can be used as surrogate marker in identifying patients for aggressive treatment but it needs validateion by large RCT