CYFRA 21-1 as a Predictive Marker for Non-small Cell Lung Cancer Treated with Pemetrexed-based Chemotherapy.

Background: Pretreatment serum tumor marker levels predict outcome in non-small cell lung cancer (NSCLC). However, little is known about the clinical value of such measurements for patients treated with pemetrexed plus a platinum-derivative.

Patients And Methods: We retrospectively screened 100 chemotherapy-naïve patients with advanced non-squamous NSCLC treated with pemetrexed plus a platinum-derivative in relation to the pretreatment level of cytokeratin 19 fragment (CYFRA 21-1) and carcinoembryonic antigen (CEA).

Results: Sixty one patients with a high CYFRA 21-1 level had statistically shorter progression-free and overall survival than 39 patients with a normal CYFRA 21-1 level (median progression-free survival=127 days vs. 191 days, respectively; p=0.046; median overall survival=360 days vs. 781 days, respectively, p<0.001). Serum CEA level was not related to survival.

Conclusion: Serum CYFRA 21-1 level is a predictive and prognostic marker in patients with NSCLC treated with pemetrexed plus a platinum-derivative.