Anti-Hu antibodies in patients with small-cell lung cancer: association with complete response to therapy and improved survival

J Clin Oncol. 1997 Aug;15(8):2866-72. doi: 10.1200/JCO.1997.15.8.2866.

Abstract

Purpose: Anti-Hu antibodies (HuAb) recognize antigens expressed by neurons and small-cell lung cancer (SCLC). High titers of HuAb were initially reported in serum from patients with paraneoplastic encephalomyelitis/sensory neuropathy (PEM/SN) and SCLC. Preliminary studies have indicated that some SCLC patients without PEM/SN harbor low titer of HuAb in their serum, and that the SCLC of these patients may grow more indolently. Based on these observations, we conducted a multicenter prospective study of SCLC patients without PEM/SN to determine the incidence and prognostic implications of HuAb.

Methods: Serum samples were collected at diagnosis of SCLC in 196 patients without PEM/SN. HuAb were determined by immunoblot of purified recombinant HuD antigen.

Results: HuAb were detected in 32 (16%) of the 196 patients. Of the 170 patients who received treatment for the tumor, 27 (16%) were HuAb positive. HuAb was associated with limited disease stage (59.3% v 38.6%; P = .047), complete response to therapy (55.6% v 19.6%; P < .001), and longer survival (14.9 v 10.2 months; P = .018). In a logistic regression analysis, HuAb status was an independent predictor of complete response induction. The probability of achieving a complete response was more than five times higher in HuAb-positive than in HuAb-negative patients (odds ratio, 5.4; 95% confidence interval, 1.71 to 16.89; P = .004). Cox multivariate analysis indicated that HuAb status was not independently associated with survival.

Conclusion: The presence of HuAb at diagnosis of SCLC is a strong and independent predictor of complete response to treatment. This feature accounts for the association between HuAb and longer survival.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Antibodies, Neoplasm / analysis*
  • Biomarkers, Tumor / analysis*
  • Blotting, Western
  • Carcinoma, Small Cell / diagnosis
  • Carcinoma, Small Cell / immunology*
  • Carcinoma, Small Cell / mortality
  • Carcinoma, Small Cell / therapy
  • Central Nervous System Diseases / immunology
  • ELAV Proteins
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / immunology*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Nerve Tissue Proteins / immunology*
  • Paraneoplastic Syndromes / immunology
  • Prognosis
  • Prospective Studies
  • RNA-Binding Proteins / immunology*
  • Regression Analysis
  • Survival Rate
  • Treatment Outcome

Substances

  • Antibodies, Neoplasm
  • Biomarkers, Tumor
  • ELAV Proteins
  • Nerve Tissue Proteins
  • RNA-Binding Proteins