A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test

This study aimed to investigate whether changes in progastrin-releasing peptide (ProGRP) levels correlate with treatment response and can be used to optimize clinical management of patients with small-cell lung cancer. Patients with small-cell lung cancer (any stage) receiving chemotherapy were elig...

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Main Authors: Thomas Muley, Xiaotong Zhang, Stefan Holdenrieder, Catharina M Korse, Xiu-yi Zhi, Rafael Molina, Zhongjuan Liu, Gunther Hartmann, Michel M van den Heuvel, Kun Qian, Ramon Marrades, Christine Engel, Ying He, Birgit Wehnl, Farshid Dayyani, Felix Herth
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Language:English
Published: SAGE Publishing 2020-09-01
Series:Tumor Biology
Online Access:https://doi.org/10.1177/1010428320958603
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author Thomas Muley
Xiaotong Zhang
Stefan Holdenrieder
Catharina M Korse
Xiu-yi Zhi
Rafael Molina
Zhongjuan Liu
Gunther Hartmann
Michel M van den Heuvel
Kun Qian
Ramon Marrades
Christine Engel
Ying He
Birgit Wehnl
Farshid Dayyani
Felix Herth
author_facet Thomas Muley
Xiaotong Zhang
Stefan Holdenrieder
Catharina M Korse
Xiu-yi Zhi
Rafael Molina
Zhongjuan Liu
Gunther Hartmann
Michel M van den Heuvel
Kun Qian
Ramon Marrades
Christine Engel
Ying He
Birgit Wehnl
Farshid Dayyani
Felix Herth
author_sort Thomas Muley
collection DOAJ
description This study aimed to investigate whether changes in progastrin-releasing peptide (ProGRP) levels correlate with treatment response and can be used to optimize clinical management of patients with small-cell lung cancer. Patients with small-cell lung cancer (any stage) receiving chemotherapy were eligible. ProGRP was measured in serum/plasma at baseline and after each chemotherapy cycle using the Elecsys ® ProGRP assay (Roche Diagnostics). Treatment response was assessed by computed tomography scan. The primary objective was to examine whether changes in ProGRP levels correlated with computed tomography scan results after two cycles of chemotherapy. The prognostic value of ProGRP among patients receiving first-line chemotherapy was also assessed. Overall, 261 patients from six centers were eligible. Among patients with elevated baseline ProGRP (>100 pg/mL), a ProGRP decline after Cycle 2 was associated with nonprogression (area under the curve: 84%; 95% confidence interval: 72.8–95.1; n = 141). ProGRP changes from baseline to end of Cycle 1 were predictive of response, as determined by computed tomography scan 3 weeks later (area under the curve: 87%; 95% confidence interval: 74.1−99.2; n = 137). This was enhanced by repeat measurements, with a 92% area under the curve (95% confidence interval: 85.3−97.8) among patients with ProGRP data after both Cycles 1 and 2 (n = 123); if a patient experienced a ≥25% decline in ProGRP after Cycle 1, and ProGRP remained stable or decreased after Cycle 2, the probability of finding progression on the interim computed tomography scan at the end of Cycle 2 was almost zero (sensitivity: 100%, specificity: 71%). Both ProGRP levels at baseline and at the end of first-line chemotherapy were prognostic; the latter provided a moderately improved hazard ratio of 2.43 (95% confidence interval: 1.33–4.46; n = 110) versus 1.87 (95% confidence interval: 1.04–3.37; n = 216). In summary, for patients with small-cell lung cancer and elevated baseline ProGRP levels, ProGRP may be a simple, reliable, and repeatable tool for monitoring response to chemotherapy and provide valuable prognostic information.
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publishDate 2020-09-01
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record_format Article
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spelling doaj-art-de453d033ca24de7ad50985f43964c442025-08-20T02:54:50ZengSAGE PublishingTumor Biology1423-03802020-09-014210.1177/1010428320958603A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood testThomas Muley0Xiaotong Zhang1Stefan Holdenrieder2Catharina M Korse3Xiu-yi Zhi4Rafael Molina5Zhongjuan Liu6Gunther Hartmann7Michel M van den Heuvel8Kun Qian9Ramon Marrades10Christine Engel11Ying He12Birgit Wehnl13Farshid Dayyani14Felix Herth15Translational Lung Research Center (TLRC) Heidelberg, German Center for Lung Research (DZL), Heidelberg, GermanyPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaUniversity Hospital Bonn, Bonn, GermanyThe Netherlands Cancer Institute, Amsterdam, The NetherlandsXuanwu Hospital, Capital Medical University, Beijing, ChinaHospital Clinic, University of Barcelona, Barcelona, SpainPeking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, ChinaUniversity Hospital Bonn, Bonn, GermanyRadboud University Medical Center, Nijmegen, The NetherlandsXuanwu Hospital, Capital Medical University, Beijing, ChinaHospital Clinic, University of Barcelona, Barcelona, SpainRoche Diagnostics GmbH, Penzberg, GermanyRoche Diagnostics GmbH, Penzberg, GermanyRoche Diagnostics GmbH, Penzberg, GermanyUniversity of California, Irvine, Irvine, CA, USATranslational Lung Research Center (TLRC) Heidelberg, German Center for Lung Research (DZL), Heidelberg, GermanyThis study aimed to investigate whether changes in progastrin-releasing peptide (ProGRP) levels correlate with treatment response and can be used to optimize clinical management of patients with small-cell lung cancer. Patients with small-cell lung cancer (any stage) receiving chemotherapy were eligible. ProGRP was measured in serum/plasma at baseline and after each chemotherapy cycle using the Elecsys ® ProGRP assay (Roche Diagnostics). Treatment response was assessed by computed tomography scan. The primary objective was to examine whether changes in ProGRP levels correlated with computed tomography scan results after two cycles of chemotherapy. The prognostic value of ProGRP among patients receiving first-line chemotherapy was also assessed. Overall, 261 patients from six centers were eligible. Among patients with elevated baseline ProGRP (>100 pg/mL), a ProGRP decline after Cycle 2 was associated with nonprogression (area under the curve: 84%; 95% confidence interval: 72.8–95.1; n = 141). ProGRP changes from baseline to end of Cycle 1 were predictive of response, as determined by computed tomography scan 3 weeks later (area under the curve: 87%; 95% confidence interval: 74.1−99.2; n = 137). This was enhanced by repeat measurements, with a 92% area under the curve (95% confidence interval: 85.3−97.8) among patients with ProGRP data after both Cycles 1 and 2 (n = 123); if a patient experienced a ≥25% decline in ProGRP after Cycle 1, and ProGRP remained stable or decreased after Cycle 2, the probability of finding progression on the interim computed tomography scan at the end of Cycle 2 was almost zero (sensitivity: 100%, specificity: 71%). Both ProGRP levels at baseline and at the end of first-line chemotherapy were prognostic; the latter provided a moderately improved hazard ratio of 2.43 (95% confidence interval: 1.33–4.46; n = 110) versus 1.87 (95% confidence interval: 1.04–3.37; n = 216). In summary, for patients with small-cell lung cancer and elevated baseline ProGRP levels, ProGRP may be a simple, reliable, and repeatable tool for monitoring response to chemotherapy and provide valuable prognostic information.https://doi.org/10.1177/1010428320958603
spellingShingle Thomas Muley
Xiaotong Zhang
Stefan Holdenrieder
Catharina M Korse
Xiu-yi Zhi
Rafael Molina
Zhongjuan Liu
Gunther Hartmann
Michel M van den Heuvel
Kun Qian
Ramon Marrades
Christine Engel
Ying He
Birgit Wehnl
Farshid Dayyani
Felix Herth
A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test
Tumor Biology
title A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test
title_full A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test
title_fullStr A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test
title_full_unstemmed A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test
title_short A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test
title_sort continuous responder algorithm to optimize clinical management of small cell lung cancer with progastrin releasing peptide as a simple blood test
url https://doi.org/10.1177/1010428320958603
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