Correlation of C-reactive protein with survival and radiographic response to first-line platinum-based chemotherapy in advanced non-small cell lung cancer

Onkologie. 2008 Dec;31(12):665-70. doi: 10.1159/000165054. Epub 2008 Nov 14.

Abstract

Objective: This study was conducted to assess the prognostic role of regular measurements of C-reactive protein (CRP) in patients with advanced-stage non-small cell lung cancer (NSCLC) during platinum-based first-line therapy.

Methods: A total of 210 patients were retrospectively analyzed regarding CRP values, infections, histological type, stage, performance status, gender, age, body mass index and survival. Additionally, in 88 of these patients, changes of CRP values were correlated with response to chemotherapy by radiographic imaging.

Results: Elevation of CRP prior to the first cycle was an adverse prognostic factor for overall survival. Comparing CRP values before and after 2 cycles correlated with response and identified patient groups with a remarkable difference of overall survival (18.8 vs. 7.5 months). Normalization of CRP was associated with a low risk for progression, whereas patients with an increase of CRP values of more than 25% showed a progressive disease in most cases. Besides performance status, no correlation of CRP with other clinical data was found.

Conclusions: Measurement of CRP before initiation and during a platinum-based chemotherapy can provide prognostic information for the individual patient with advanced NSCLC and is able to support or even replace assessment of response by radiographic imaging in defined situations.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • C-Reactive Protein / analysis*
  • Carcinoma, Non-Small-Cell Lung* / blood
  • Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / mortality
  • Female
  • Germany / epidemiology
  • Humans
  • Lung Neoplasms* / blood
  • Lung Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / mortality
  • Male
  • Middle Aged
  • Platinum Compounds / therapeutic use*
  • Prognosis
  • Radiography
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Statistics as Topic
  • Survival Analysis*
  • Survival Rate
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Platinum Compounds
  • C-Reactive Protein