title: Prognostic and predictive value of plasma D-dimer in advanced non-small cell lung cancer patients undergoing first-line chemotherapy.
abstract: OBJECTIVE
  Previous studies have demonstrated that plasma D-dimer, a degradation product of cross-linked fibrin, correlated with tumor stage and prognosis in cancer patients. The aim of this study is to examine whether plasma D-dimer levels before and during chemotherapy predict tumor response and survival in advanced NSCLC patients undergoing first line chemotherapy.
  
  
  METHODS
  Plasma D-dimer levels before (B0), and after one (B1) and two (B2) cycles of chemotherapy in 82 patients with advanced NSCLC were measured and correlated with treatment response, clinical features, progression-free survival (PFS) and overall survival.
  
  
  RESULTS
  A significant correlation was identified between changes in D-dimer levels before and after two chemotherapy cycles and treatment response. In addition, there were significant correlations between D-dimer positivity at B0, B1 and B2 time points and tumor stage, number of metastatic sites and treatment response. Patients with positivity of D-dimer at B0, B1 and B2 had significantly shorter PFS compared with those with negativity. Notably, positivity of D-dimer at B1 and B2 time points was an independent predictive factor for unfavorable PFS.
  
  
  CONCLUSIONS
  The positivity of D-dimer before and during chemotherapy is a predictor of treatment response and worse PFS in patients with advanced NSCLC. D-dimer levels provide prognostic information in addition to that of imaging studies.
authors.affiliation: Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, 438 North Jiefang Street, Zhenjiang, 212001, China.
authors.forename: L-P
authors.initials: LP
authors.lastname: Ge
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: Q-L
authors.initials: QL
authors.lastname: Bao
authors.forename: P
authors.initials: P
authors.lastname: Chen
authors.forename: Q
authors.initials: Q
authors.lastname: Jiang
authors.forename: L-R
authors.initials: LR
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000737:chemistry / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000188:drug therapy*; D003432:Cross-Linking Reagents / Q000737:chemistry; D018572:Disease-Free Survival; D005260:Female; D005337:Fibrin / Q000737:chemistry; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D003432:Cross-Linking Reagents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005337:Fibrin