Publication details

Prognostic role of serum C-reactive protein in patients with advanced-stage NSCLC treated with pemetrexed

Authors

FIALA O. HOSEK P. PESEK M. FINEK J. RACEK J. BUCHLER T. POPRACH Alexandr HEJDUK Karel CHLOUPKOVÁ Renata SOREJS O. ECKSTEINOVA M. VITOVEC M. CIZKOVA K. KUCERA R. TOPOLCAN O.

Year of publication 2017
Type Article in Periodical
Magazine / Source Neoplasma
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.4149/neo_2017_416
Field Oncology and hematology
Keywords C-reactive protein; lung cancer; NSCLC; chemotherapy; pemetrexed; prognosis
Description Pemetrexed is an intravenously administered antifolate cytostatic agent targeting several folate-dependent enzymatic pathways, widely used in the treatment of patients with advanced non-small cell lung cancer (NSCLC). It has been previously demonstrated that the superiority of pemetrexed is limited to patients with non-squamous histology. Aside from the non-squamous histology, there is still no available molecular biomarker predicting treatment efficacy of pemetrexed-based chemotherapy. The aim of our retrospective study was to evaluate the association of baseline serum levels of C-reactive protein (CRP) with outcomes in a large cohort of patients with non-squamous NSCLC treated with pemetrexed. Clinical data of 325 patients were analysed. Serum samples were collected within one week before the initiation of treatment. The median progression-free (PFS) and overall survival (OS) for patients with high CRP was 2.1 and 9.5 compared to 4.2 and 20.5 months for those with normal CRP (p=0.002 and p<0.001, respectively). The multivariable Cox proportional hazards model revealed that serum CRP (HR=1.46, p=0.002) was significantly associated with PFS and also with OS (HR=1.95, p<0.001). In conclusion, the study results suggest that pretreatment serum CRP is associated with poor outcome of non-squamous NSCLC patients treated with pemetrexed.

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