470P - Prognostic significance of serum biomarkers in small cell lung cancer: A meta-analysis and systematic review

Background

Due to its high propensity for metastasis and lack of durable response to therapy, several biomarkers have been studied to help predict outcomes in patients with Small Cell Lung Cancer (SCLC). These biomarkers aid the clinicians in their treatment decisions among these patients. Neuron-specific enolase (NSE), can be used in supporting a diagnosis of SCLC. However, little is known on its prognostic significance due to the limited number of studies conducted. Carcino-embryonic antigen (CEA) can be used in treatment monitoring and prognostication in several cancers. Few studies have been conducted among SCLC patients investigating its prognostic significance. Moreover, no meta-analysis has been conducted on this outcome. Vascular endothelial growth factor (VEGF) plays an important role in the dissemination of malignancy. Although serum VEGF is found many cancer patients, little is known about its prognostic significance among SCLC. Moreover, no meta-analysis has been conducted on this outcome. This study aims to conduct a systematic review and meta-analysis on the prognostic significance of the CEA, NSE and VEGF on SCLC.

Methods

A systematic review was conducted to examine the prognostic significance of three biomarkers in the prognosis of SCLC: CEA, VEGF and NSE. Systematic search was done using Pubmed, Cochraine and EMBASE for articles published until July 1, 2019. Seventeen studies with a total of 3, 973 patients were included in the analysis. The primary outcome of interest was Overall Survival in SCLC. Data was summarized using RevMan 5.3. Preplanned subgroup analysis was done on the type of study and the statistic used.

Results

High CEA (HR 1.28 95%CI 1.10-1.50, p < 0.001, I² 45%) and VEGF (HR 1.84 CI 1.21-2.78 p = 0.004, I² 52%) were both associated with poor overall survival. NSE was associated with poor overall survival based on pooled retrospective studies (HR 1.42 CI 1.22-1.67, p < 0.00001, I² 34%) and prospective studies (RR 1.68 CI 1.40-2.02, p < 0.00001, I² 50%). Pooled HR for prospective studies was not significant (HR 2.32 CI 0.96-5.56, p = 0.06, I² 83%).

Conclusions

High NSE, CEA and VEGF may be used as prognostic biomarkers of poor survival in patients with SCLC. Further randomized studies may confirm these findings.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

D.B.L. Sacdalan: Honoraria (self): Merck. All other authors have declared no conflicts of interest.