Lung Cancer |

The Difference of Tumor Markers According to the EGFR Mutation and ALK Rearrangement in the Patients With Advanced Adenocarcinoma of the Lung FREE TO VIEW

Young Whan Kim, PhD; Ju-Hee Park; Young Sik Park; Chang-Hoon Lee, PhD; Sang-Min Lee, PhD; Jae-Joon Yim, PhD; Sung Koo Han, PhD; Chul-Gyu Yoo, PhD
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Seoul National University Hospital, Seoul, Republic of Korea

Chest. 2014;146(4_MeetingAbstracts):588A. doi:10.1378/chest.1991270
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SESSION TITLE: Lung Cancer Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Testing for specific gene mutations and rearrangements are recommended for adenocarcinoma of lung patients so that patients with these genetic abnormalities can receive effective treatment. Also, tumor markers are widely used in management to aid diagnosis, to evaluate effectiveness of treatments, to mointor for recurrence after therapy and to predict prognostic information. The association of tumor marker and specific genetic alteration has not been clear. We evaluated the difference of tumor markers according to the specific gene alterations.

METHODS: In this retrospective study, patients with stage 3 and 4 lung adenocarcinoma newly diagnosed in Seoul National University Hospital, between June 2011 and December 2011 were reviewed. We analyzed tumor marker level of Carcinoembryonic antigen(CEA), Cytokeratin 19 fragments (CYFRA21-1) from patients who evaluated both epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) gene rearrangement.

RESULTS: A total of 248 patients were reveiwed. EGFR mutation and ALK rearrangement negative, EGFR mutation and ALK rearrangement were 114 (46.0%), 106 (42.7%) and 28 (11.3%) patients, respectively. Median serum CEA levels were 5.2ng/ml in EGFR and ALK negative group, 14.40ng/ml in EGFR mutation group, 2.00ng/ml in ALK rearrangement group. And serum CEA levels of EGFR mutation group were elevated compared with other groups (p<0.001). Median serum CYFRA 21-1 levels were 5.03ng/ml in EGFR and ALK negative group, 4.47ng/ml in EGFR mutation group, 2.00ng/ml in ALK rearrangement group. And serum CYFRA 21-1 levels of ALK rearrangement group were lower than EGFR and ALK negative group (p=0.002).

CONCLUSIONS: In advanced lung adenocarcinoma, both CEA and CYFRA 21-1 were show difference according to EGFR mutation and ALK rearrangement. In patients with EGFR mutations, median CEA level and the proportion of abnormal CEA level were high and median CYFRA 21-1 level and the proportion of abnormal CYFRA 21-1 level were low in patients with ALK gene rearrangement.

CLINICAL IMPLICATIONS: Motoring tumor markers may be useful in EGFR mutation positive adenocarcinoma of the lung. However, new tumor markers should be explored to use in ALK rearrangement adenocarcinoma of the lung.

DISCLOSURE: The following authors have nothing to disclose: Young Whan Kim, Ju-Hee Park, Young Sik Park, Chang-Hoon Lee, Sang-Min Lee, Jae-Joon Yim, Sung Koo Han, Chul-Gyu Yoo

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