Baseline Levels and Decrease in Serum Soluble Intercellular Adhesion Molecule-1 During Chemotherapy Predict Objective Response and Survival in Patients Who Have Advanced Non–Small-Cell Lung Cancer

BackgroundThis study assesses the predictive and prognostic roles of serum soluble intercellular adhesion molecule-1 (sICAM-1) and vascular endothelial growth factor (VEGF) during chemotherapy in patients with advanced non–small-cell lung cancer (NSCLC).Patients and MethodsChanges in serum levels of sICAM-1 and VEGF during first-line conventional chemotherapy were studied prospectively using an enzyme-linked immunosorbent assay at baseline and after every two courses of therapy in 124 patients who have advanced NSCLC. Data were correlated with radiologic objective response and survival.ResultsThe prognostic values of serum sICAM-1and VEGF were explored in 115 advanced NSCLC patients and 61 patients were evaluated for radiologic and serologic responses after two chemotherapy courses. Of the 115 patients, 79 patients had baseline serum sICAM-1 levels greater than 232.84 ng/mL, which is the cut-off value for distinguishing malignant tumors from benign. Statistically significant correlations were observed between baseline sICAM-1 levels and odds ratios and between a sICAM-1 response and odds ratios (8.05 and 5.40, respectively). However, there was no correlation between baseline VEGF levels and odds ratios (P = .543). The median progression-free survival from response assessment was 4 months. In a multivariate analysis, performance status (hazard ratio [HR], 1.47; 95% confidence interval [CI] (95% CI), 1.03-2.10), disease stage (HR, 1.43; 95% CI, 1.07-1.90), baseline sICAM-1 (HR, 1.12; 95% CI, 1.01-1.21), and sICAM-1 response (HR, 0.58; 95%CI, 0.39-0.88), were confirmed as independent prognostic factors for survival.ConclusionBaseline sICAM-1 and sICAM-1 responses appeared to be reliable surrogate markers of chemotherapy efficacy and were prognostic factors in patients with advanced NSCLC.