Development and Validation of a Prognostic Model Using Blood Biomarker Information for Prediction of Survival of Non-Small-Cell Lung Cancer Patients Treated With Combined Chemotherapy and Radiation or Radiotherapy Alone (NCT00181519, NCT00573040, and NCT00572325)
- Department of Radiation Oncology (MAASTRO Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht (Netherlands)
- Siemens Medical Solutions, Malvern, PA (United States)
- Department of Clinical Chemistry, Maastricht University Medical Centre, Maastricht (Netherlands)
- Institute of Medical Technology, University of Tampere, Tampere (Finland)
Purpose: Currently, prediction of survival for non-small-cell lung cancer patients treated with (chemo)radiotherapy is mainly based on clinical factors. The hypothesis of this prospective study was that blood biomarkers related to hypoxia, inflammation, and tumor load would have an added prognostic value for predicting survival. Methods and Materials: Clinical data and blood samples were collected prospectively (NCT00181519, NCT00573040, and NCT00572325) from 106 inoperable non-small-cell lung cancer patients (Stages I-IIIB), treated with curative intent with radiotherapy alone or combined with chemotherapy. Blood biomarkers, including lactate dehydrogenase, C-reactive protein, osteopontin, carbonic anhydrase IX, interleukin (IL) 6, IL-8, carcinoembryonic antigen (CEA), and cytokeratin fragment 21-1, were measured. A multivariate model, built on a large patient population (N = 322) and externally validated, was used as a baseline model. An extended model was created by selecting additional biomarkers. The model's performance was expressed as the area under the curve (AUC) of the receiver operating characteristic and assessed by use of leave-one-out cross validation as well as a validation cohort (n = 52). Results: The baseline model consisted of gender, World Health Organization performance status, forced expiratory volume, number of positive lymph node stations, and gross tumor volume and yielded an AUC of 0.72. The extended model included two additional blood biomarkers (CEA and IL-6) and resulted in a leave-one-out AUC of 0.81. The performance of the extended model was significantly better than the clinical model (p = 0.004). The AUC on the validation cohort was 0.66 and 0.76, respectively. Conclusions: The performance of the prognostic model for survival improved markedly by adding two blood biomarkers: CEA and IL-6.
- OSTI ID:
- 21587745
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 81, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2010.06.011; PII: S0360-3016(10)00820-5; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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BIOLOGICAL MARKERS
BLOOD
CARBONIC ANHYDRASE
CARCINOEMBRYONIC ANTIGEN
CHEMOTHERAPY
INFLAMMATION
LACTATE DEHYDROGENASE
LUNGS
LYMPH NODES
MULTIVARIATE ANALYSIS
NEOPLASMS
RADIOTHERAPY
VALIDATION
ANTIGENS
BIOLOGICAL MATERIALS
BODY
BODY FLUIDS
CARBON-OXYGEN LYASES
DISEASES
ENZYMES
HEMIACETAL DEHYDROGENASES
HYDRO-LYASES
LYASES
LYMPHATIC SYSTEM
MATERIALS
MATHEMATICS
MEDICINE
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
OXIDOREDUCTASES
PATHOLOGICAL CHANGES
PROTEINS
RADIOLOGY
RESPIRATORY SYSTEM
STATISTICS
SYMPTOMS
TESTING
THERAPY