title: High pre-treatment serum level of vascular endothelial growth factor (VEGF) is associated with poor outcome in small-cell lung cancer.
abstract: Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and vascular permeability. Increased serum VEGF concentrations (S-VEGF) have been found in patients with various types of human cancer, including cancer of the lung. However, the clinical and prognostic significance of S-VEGF in cancer is unknown. We measured S-VEGF, using enzyme-linked immunosorbent assay, in sera taken from 68 untreated patients with small-cell lung cancer (SCLC) at the time of diagnosis. The patients were treated with 6 cycles of cisplatin and etoposide, and were randomly assigned to receive recombinant interferon, leukocyte interferon or neither. S-VEGF ranged from 70 to 1738 pg/ml (mean, 527 pg/ml). The patients who achieved partial or complete response to treatment had lower pre-treatment S-VEGF than the non-responding patients (p = 0.0083, Mann-Whitney test). High (>527 pg/ml) S-VEGF was associated with poor survival (p = 0.012, Log Rank Test), and all 3-year survivors had lower than mean pre-treatment S-VEGF. In a multivariate analysis, S-VEGF and stage were the only independent prognostic factors, and the estimated 3-year survival of the patients with limited stage disease and low pretreatment S-VEGF (n = 17, 25% of all patients) was 41% (p = 0.0055, log rank test). These data show that high pretreatment S-VEGF is associated with poor response to treatment and unfavourable survival in patients with SCLC treated with combination chemotherapy with or without interferon.
authors.affiliation: Department of Oncology, Helsinki University Central Hospital, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Salven
authors.forename: T
authors.initials: T
authors.lastname: Ruotsalainen
authors.forename: K
authors.initials: K
authors.lastname: Mattson
authors.forename: H
authors.initials: H
authors.lastname: Joensuu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D018288:Carcinoma, Small Cell / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016228:Endothelial Growth Factors / Q000097:blood*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008222:Lymphokines / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011994:Recombinant Proteins; D016019:Survival Analysis; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
chemical_list: D014408:Biomarkers, Tumor; D016228:Endothelial Growth Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D008222:Lymphokines; D011994:Recombinant Proteins; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors; D005047:Etoposide; D002945:Cisplatin