[Biological variables and stratification of patients with inoperable non-small-cell bronchial cancer: recommendations for future trials].
OBJECTIVE
To identify, through a review of the literature, the laboratory variables that would allow a more accurate stratification of unresected non small-cell lung cancer patients who participate in clinical trials.


METHODS
Systematic review, without meta-analysis, following the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine, and taking into account the Consolidated Standards of Reporting Trials statement.


RESULTS
Of 1106 publications retrieved, we were able to include only fourteen studies in our review. Available evidence would support the use of several laboratory variables as prognostic covariables to stratify non resected non small-cell lung cancer patients in clinical trials, but blood haemoglobin would be the only one that could be recommended on a routine basis, and only in patients treated with radiotherapy (three studies out of three). The possible consequences in terms of therapeutic decision of haemoglobin measurements remain however to be clarified.


CONCLUSIONS
Until better designed studies are published, a number of arguments would support the pre-treatment measurements of the following variables in patients participating in clinical trials: blood haemoglobin, white blood cell count with differential, serum LDH, albumin, calcium, and NSE. Further studies would also be necessary to support the addition to this list, of other tumour markers (including Cyfra 21-1), and/or measurements during or after treatment.
Watine
J
J
Laboratoire de biologie polyvalente, centre hospitalier général, 12027 Rodez, France. j.watine@ch-rodez.fr
Friedberg
B
B
Bouarioua
N
N
D014408:Biomarkers, Tumor / Q000097:blood; D001984:Bronchial Neoplasms / Q000097:blood* / Q000145:classification / Q000401:mortality / Q000628:therapy; D002118:Calcium / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000145:classification / Q000401:mortality / Q000628:therapy; D002986:Clinical Trials as Topic / Q000379:methods*; D019317:Evidence-Based Medicine; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007958:Leukocyte Count; D008175:Lung Neoplasms; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011379:Prognosis; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D006454:Hemoglobins; D012709:Serum Albumin; D007770:L-Lactate Dehydrogenase; D010751:Phosphopyruvate Hydratase; D002118:Calcium