title: Lack of utility of plasma TNF-alpha level in predicting therapeutic efficacy in patients with advanced non-small cell lung cancer.
abstract: BACKGROUND
  Accumulating evidence suggests a change in cytokine profile after cytotoxic therapies. We hypothesized that change in plasma levels of tumor necrosis factor-alpha (TNF-alpha) during the course of chemotherapy in lung cancer may predict therapeutic efficacy at an early stage.
  
  
  METHODS
  Plasma TNF-alpha levels were quantified before first, second, and third cycle of chemotherapy in 42 patients with advanced non-small cell lung cancer and correlated with response to therapy as assessed by computed tomography after the third chemotherapy cycle.
  
  
  RESULTS
  Plasma levels of TNF-alpha measured before various treatment cycles could not differentiate among patients with remission, no change, and progression. For predicting inadequate therapeutic response, a sensitivity of 11.5% and 23.1% was achieved at 100% specificity using plasma TNF-alpha levels measured before first and second therapy cycle, respectively. Prediction of disease progression was achieved with a sensitivity of 14.3% at 100% specificity for plasma TNF-alpha levels measured before second therapy cycle. Plasma levels of TNF-alpha measured before various treatment cycles was not correlated with survival.
  
  
  CONCLUSIONS
  Measurement of plasma TNF-alpha may not prove to be a good biomarker for predicting therapeutic efficacy at an early stage in NSCLC. Additional, more specific, and more sensitive blood-based biomarkers will be required to further improve the diagnostic power of current imaging tools for indicating early therapeutic efficacy.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110 029, India.
authors.forename: Sachin
authors.initials: S
authors.lastname: Kumar
authors.forename: Randeep
authors.initials: R
authors.lastname: Guleria
authors.forename: Vikas
authors.initials: V
authors.lastname: Singh
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.forename: Alok C
authors.initials: AC
authors.lastname: Bharti
authors.forename: Bhudev C
authors.initials: BC
authors.lastname: Das
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D014409:Tumor Necrosis Factor-alpha