157P - Serum tumor markers and the response to immunotherapy in advanced non-small cell lung carcinoma

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Immunotherapy
Translational Research
Non-small-cell lung cancer
Basic Principles in the Management and Treatment (of cancer)
Therapy
Presenter Annemarie Essink
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors A. Essink1, T. Korse2, M. Vd Heuvel2
  • 1Pulmonology, Het Nederlands Kanker Instituut Antoni van Leeuwenhoek (NKI-AVL), 2518 EC - Amsterdam/NL
  • 2Pulmonology, Het Nederlands Kanker Instituut Antoni van Leeuwenhoek (NKI-AVL), Amsterdam/NL

Abstract

Background

Introduction of immunotherapy in advanced non-small cell lung carcinoma (NSCLC) has revolutionized therapy. Radiological response assessment however, has become more complex. Objective tools are needed to prevent continuation of unnecessary and costly treatment. It was hypothesized that serum tumor markers provide additive value.

Methods

For the analysis we included 65 patients with advanced NSCLC (all histologies) who were treated with immunotherapy in different clinical trials between 2013 and 2015. Serum tumor markers were measured at baseline and every visit. Response criteria of tumor markers were based on the reference change value (RCV) according to the Westgard method of biological variation resulting in RCV for Cyfra 21.1, CEA, SCC, CA125 and NSE of 58%, 33%, 103%, 64% and 35%, respectively. All serum tumor markers were analyzed both separately and in combination and results were reported as not assessable (= NA, markers stay below upper limit of normal), response (MD = marker decrease), no change (MS = marker stable), progression (ME = marker elevation) or mixed response (MMR = mixed marker response). Radiologic assessment was performed at 6-weekly intervals according to RECIST and best overall response was used for the current analysis.

Results

At time of reporting 62 out of 65 patients received single agent PD (L) monoclonal antibodies, and 3 patients received both PD(L)1 and CTLA-4 blockade. Twenty-one patients (32%) had a radiologic response. Of those 38% had MD, 9% MS or NA, 14% ME, and 38% MMR. Twenty patients (31%) had radiologic stable disease, in this group 20% had MD, 0% MS, 45% ME and 35% MMR. Twenty-two patients (34%) had radiologic progressive disease, with 14% MD, 36% MS, 45% ME, and 5% MMR. Two patients died before radiologic response measurement, they both had progressive tumor markers and no clinical response. Concordance between radiology and tumor markers was best for Cyfra21.1: Eighty-one percent of radiological response patients had either NA, MS or MD and ninety-one percent of progressive disease patients had either ME, MS or MMR.

Conclusions

Serum tumor markers can be used for monitoring response to immunotherapy in patients with advanced stage NSCLC.

Clinical trial identification

Legal entity responsible for the study

Antoni van Leeuwenhoek hospital

Funding

Antoni van Leeuwenhoek hospital

Disclosure

All authors have declared no conflicts of interest.