کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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2010604 | 1400743 | 2016 | 9 صفحه PDF | دانلود رایگان |
BackgroundProgression of lung cancer is associated with some abnormalities in coagulation. The aim of the study was to determine the predictive and prognostic value of changes in D-dimer concentration in non-small cell lung cancer (NSCLC) patients on anti-EGFR targeted therapy.MethodsThe analysis included fifty two NSCLC patients treated with EGFR tyrosine kinase inhibitors (TKIs): erlotinib or gefitinib. All clinical data were collected before treatment and after 2 cycles (60 days) of therapy and correlated with progression free and overall survival (PFS, OS).ResultsTwo iatrogenic events were noted within the first 60 days of anti-EGFR treatment: typical skin rash in 38 (73.1%) and a decrease in D-dimer concentration in 26 (50%) patients. Multivariate analysis revealed a decrease of D-dimer concentration as the strongest factor associated with longer PFS (HR = 0.39; 95%CI: 0.16–0.91; p = 0.029) and OS (HR = 0.33; 95%CI: 0.13–0.82, p = 0.017) independently of skin rash, baseline level of D-dimer and other clinical characteristics. Coexisting a decrease in D-dimer concentration with an occurrence of skin rash correlated significantly with the positive objective response after 60 days of anti-EGFR therapy (p = 0.0175) and indicated the longest PFS (HR = 0.31; 95%CI: 0.16–0.60, p = 0.0005) as well as OS (HR = 0.30; 95%CI: 0.15–0.59, p = 0.0005).ConclusionAdverse events may predict the outcomes of cancer patients. Apart from skin rash, change in D-dimer concentration may be valuable parameter in creation of predictive and prognostic models in NSCLC patients receiving anti-EGFR targeted therapy.
Journal: Pharmacological Reports - Volume 68, Issue 6, December 2016, Pages 1140–1148