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David Lang

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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      159P - Initial serum tumor marker dynamics predict progression-free and overall survival in single PD-1/PD-L1 inhibitor treated advanced NSCLC (ID 218)

      12:30 - 13:00  |  Presenting Author(s): David Lang

      • Abstract
      • Slides


      Routine measurement of serum tumor markers (STM) is not recommended in advanced non-small cell lung cancer (NSCLC). However, immune checkpoint inhibitor (ICI) treated patients may initially present with indeterminate radiological response, demanding additional biomarkers aiding clinical decisions.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      Carcinoembrionic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), cytokeratin 19 fragments (CYFRA 21-1) and neuron specific enolase (NSE) were routinely measured at primary NSCLC diagnosis. The marker with the highest initial elevation above the upper limit of normal (“leading STM”) was used for follow-up. Relative leading STM changes between ICI initiation and first radiological restaging were retrospectively evaluated regarding their impact on progression-free survival (PFS) and overall survival (OS). Comparatively, we calculated PFS and OS for the corresponding computed tomography results according to response evaluation criteria in solid tumors (RECIST).

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Among 84 patients (61% men, mean age 68 years) included, median PFS was significantly (p < 0.001) longer, when the leading STM decreased (11months(M) (7,19), N = 37) than in case of marker increases (<2-fold: 6M (3,8), N = 31; ≥2-fold: 2M (1,2), N = 16). Patients with initial leading STM decrease also had significantly (p < 0.001) longer median OS (not reached) than patients with STM increase (<2-fold: 14M (12,26); ≥2-fold: 4M (3,7)). In the group with stable or progressive disease (PD/SD) according to RECIST at first restaging, PFS and OS were significantly (p < 0.001) longer upon leading STM decrease (PFS: 8M (4,14); OS: 18M (10,-); N = 24) than in case of increase (PFS: 2M (2,4); OS: 10M (6,13); N = 42).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Leading STM decrease at first restaging is predictive of longer PFS and OS in single PD-1/PD-L1 inhibitor treated NSCLC. Such tumor marker response identifies a subgroup with favorable further treatment outcomes among initial radiological non-responders.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      D. Lang, A. Horner: Travel/accommodation funding: Roche. E. Brehm: Speakers fees, consultant/advisor: Roche, Merck Sharp & Dohme, Bristol-Myers Squibb; Travel/accommodation funding: Roche, Merck Sharp & Dohme. B. Lamprecht: Speakers fees, consultant/advisor: Roche, Merck Sharp & Dohme, Bristol-Myers Squibb. All other authors have declared no conflicts of interest.


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