Multiple sequential biomarkers in monitoring patients with carcinoma of the lung.

To correlate serial biomarkers and disease activity in carcinoma of the lung, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), adrenocorticotropic hormone (ACTH), C3-derived protein (C3DP-C), and LDH were assayed in 43 patients with small cell lung carcinoma (SCLC) and in 20 patients with non-small cell lung cancer (NSCLC) (15 with adenocarcinoma, three with squamous cell carcinoma, and two with mixed histology). Disease status after treatment was rated as one of the following: complete response, partial response, minor regression, stable disease, and progressive disease. Significant correlations between disease status and markers in SCLC were found for CEA, NSE, LDH, and ACTH. In NSCLC, only CEA and LDH showed significant correlation. Marker-marker correlations were significant in SCLC for CEA and NSE (P less than 0.05), CEA and LDH (P = 0.01), and NSE and LDH (P less than 0.01); in NSCLC none were significant. None of the markers exhibited significant correlations with specific metastatic sites. Certain biomarkers (CEA, NSE, and LDH in SCLC; CEA and LDH in NSCLC) can be used alone or in combination to monitor disease activity but appear to be no more sensitive than standard clinical investigational methods.

Multiple biologic markers in the monitoring of treatment for patients with small cell carcinoma of the lung: the use of serial levels of plasma CEA and serum carbohydrates.

The monitoring utility of serial patterns of a single marker (carcinoembryonic antigen) level and multiple marker (three carbohydrates-fucose, mannose and galactose) levels in patients with small cell carcinoma of the lung was investigated using a quantitative approach. A serial multiple regression (SMR) model was formulated to assess the disease response following the first to the tenth course of therapy and resulted in the multiple correlations ranging from 0.183 (NS)-0.706 (P less than 0.005) for CEA, and 0.502 (P less than 0.250)-0.760 (P less than 0.025) for three carbohydrates, respectively. The appraisal of these markers utilizing the SMR model points out that: (1) the serial levels of CEA greater than 5.0 ng/ml are significantly correlated with the disease course whereas the serial levels less than 5.0 ng/ml reflect the trend of variation in the disease course, but with less accuracy; and (2) the levels of three carbohydrates, any one elevated before and during therapy, are significantly correlated with the disease course.