Usefulness of monitoring the circulating Krebs von den Lungen-6 levels to predict the clinical outcome of patients with advanced nonsmall cell lung cancer treated with epidermal growth factor receptor tyrosine kinase inhibitors
Article first published online: 6 MAR 2008
Copyright © 2008 Wiley-Liss, Inc.
International Journal of Cancer
Volume 122, Issue 11, pages 2612–2620, 1 June 2008
How to Cite
Ishikawa, N., Hattori, N., Yokoyama, A., Tanaka, S., Nishino, R., Yoshioka, K., Ohshimo, S., Fujitaka, K., Ohnishi, H., Hamada, H., Arihiro, K. and Kohno, N. (2008), Usefulness of monitoring the circulating Krebs von den Lungen-6 levels to predict the clinical outcome of patients with advanced nonsmall cell lung cancer treated with epidermal growth factor receptor tyrosine kinase inhibitors. Int. J. Cancer, 122: 2612–2620. doi: 10.1002/ijc.23411
- Issue published online: 25 MAR 2008
- Article first published online: 6 MAR 2008
- Manuscript Accepted: 23 NOV 2007
- Manuscript Received: 4 SEP 2007
- Ministry of Education, Culture, Sports, Science and Technology of Japan
- prognostic marker;
- lung cancer
Krebs von den Lungen-6 (KL-6) is a high molecular weight glycoprotein classified in the category of human MUC1 mucin. KL-6 has been reported to serve as a sensitive marker for interstitial pneumonia; however, recent studies have suggested that it can also be used as a tumor marker as its origin shows. To further elucidate the clinicopathological significance of circulating KL-6 in lung cancer, we monitored the circulating KL-6 levels in advanced nonsmall cell lung cancer (NSCLC) patients and analyzed the association between these levels and the clinical outcome of EGFR-TKI treatment. The pretreatment levels of circulating KL-6 were found to be significantly higher in progressive disease (PD) patients than disease-controlled (partial response (PR) and stable disease (SD)) patients. Multivariate analyses revealed the circulating KL-6 level to be an independent prognostic factor for overall survival as well as progression-free survival. In addition to these observations, we found that changes in circulating KL-6 levels at 2 weeks after the start of EGFR-TKI treatment from the baseline could quite precisely discriminate PD cases from PR or SD patients and the clinical outcome of EGFR-TKI in NSCLC patients. These results indicate that the monitoring of circulating KL-6 levels in NSCLC patients is effective for both selecting patients to be treated with EGFR-TKI and predicting the clinical outcome of EGFR-TKI. In addition, the findings suggest that the circulating KL-6 level could be used as a clinically relevant biomarker in patients with NSCLC, particularly those who are candidates for EGFR-TKI treatment. © 2008 Wiley-Liss, Inc.