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Edgar Vergara



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    P2.01 - Advanced NSCLC (ID 159)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Advanced NSCLC
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.01-40 - Normalization of Carcinoembryonic Antigen Levels Is Associated with Survival Improvement in Patients with Advanced Non-Small Cell Lung Cancer (Now Available) (ID 2611)

      10:15 - 18:15  |  Author(s): Edgar Vergara

      • Abstract
      • Slides

      Background

      Serum carcinoembryonic antigen (CEA) levels are elevated in approximately 65% of the Non-small cell lung cancer (NSCLC) patients with adenocarcinoma histology. Elevated CEA levels are an independent prognostic factor for overall survival (OS) in early and advanced NSCLC stages. Previous reports from our group suggest that the decrease or increase in CEA serum levels is strongly associated with response and progression to systemic treatment. However, determination of CEA levels is not included in standard guidelines, such as National Comprehensive Cancer Network (NCNN). The aim of this study is to analyze the progression-free survival (PFS) and overall survival (OS) in NSCLC patients with elevated CEA levels at diagnosis and its association with systemic treatment response.

      Method

      We performed a retrospective analysis of patients with advanced NSCLC with an elevated serum level baseline of CEA (>20 ng/ml) that received treatment according to international guidelines. The serum CEA levels were measured every two cycles of platinum-based chemotherapy or a tyrosine kinase inhibitor (TKI) treatment. The change in serum CEA levels in response to treatment and the association with overall survival and progression free survival was evaluated.

      Result

      Between March 2004 and February 2018, 748 patients with diagnosis of advanced NSCLC and CEA levels >20 ng/mL were included in the analysis. Median age was 60.2 years old, 631 patients (84.4%) had adenocarcinoma histology. From 338 patients evaluated for EGFR mutations, 139 (31.3%) harbored an EGFR mutation. The median OS was 23.3 months (95% CI 19.4-26.9) in patients who completely normalized CEA vs 10.0 months (95% CI 8.9-11.2) in patients who did not achieved CEA normalization, with a HR 0.48 95% CI (0.35 -0.67) p <0.0001. The median OS was 15.5 months (95% CI 13.4-17.6) in patients who showed a decrease in CEA levels vs 8.8 months (95% CI 7.5-10.1) in those who did not. Reduction in CEA levels was associated with better OS, either in patients treated with TKI or platinum-based chemotherapy.figure cea .jpg

      Conclusion

      The normalization or decrease of the serum CEA levels is a biological marker that serves as tool associated with OS. Based on these findings and previous reports, CEA determination should be included in the clinical guidelines for NSCLC as response biomarker. Serum CEA levels should be part of the standard follow-up of NSCLC patients.

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