Prognostic Role for CYFRA 21-1 in Patients With Advanced-stage NSCLC Treated With Bevacizumab Plus Chemotherapy

Anticancer Res. 2021 Apr;41(4):2053-2058. doi: 10.21873/anticanres.14974.


Aim: To investigate potential associations between selected oncomarkers [carcinoembryonic antigen (CEA), C-terminus of cytokeratin 19 (CYFRA 21-1, CYFRA), and squamous cell carcinoma antigen (SCC)] and outcomes in patients with NSCLC treated with bevacizumab plus chemotherapy.

Patients and methods: We retrospectively analysed 105 patients with NSCLC from the Czech TULUNG registry treated at University Hospital in Pilsen with bevacizumab plus chemotherapy. Response to therapy was tested by Fisher's exact test. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis.

Results: Only normal values of CYFRA (not CEA or SCC) were associated with significantly better overall and progression-free survival in univariate analysis. We also observed a trend for a better disease control rate in patients with normal levels of CYFRA. In a multivariate Cox model, only CYFRA was associated with significantly better overall but not progression-free survival.

Conclusion: In our retrospective study, we point out the possibility of using CYFRA as a prognostic marker in patients with NSCLC treated with chemotherapy plus bevacizumab.

Keywords: Bevacizumab; CEA; CYFRA; NSCLC; SCC; predictive; prognostic.

MeSH terms

  • Aged
  • Antigens, Neoplasm / analysis
  • Antigens, Neoplasm / blood
  • Antigens, Neoplasm / physiology*
  • Antineoplastic Agents / therapeutic use*
  • Bevacizumab / administration & dosage*
  • Bevacizumab / adverse effects
  • Biomarkers, Pharmacological / analysis
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / physiology
  • Carcinoembryonic Antigen / analysis
  • Carcinoembryonic Antigen / blood
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Disease Progression
  • Female
  • Humans
  • Keratin-19 / analysis
  • Keratin-19 / blood
  • Keratin-19 / physiology*
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Serpins / analysis
  • Serpins / blood
  • Treatment Outcome


  • Antigens, Neoplasm
  • Antineoplastic Agents
  • Biomarkers, Pharmacological
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • KRT19 protein, human
  • Keratin-19
  • Serpins
  • antigen CYFRA21.1
  • squamous cell carcinoma-related antigen
  • Bevacizumab