A prognostic score based on clinical factors and biomarkers for advanced non-small cell lung cancer

Aims: The objective of the present study is to determine the prognostic value of clinical variables and biomarkers in patients with advanced stages of NSCLC and establish a prognostic classification of these patients. Methods: For 135 patients with advanced NSCLC we determined their clinical variables and their levels of CEA, CA 125, CYFRA 21-1, albumin, LDH, erythrosedimentation and leukocytes. Results: Multivariate analysis identified PS (ECOG) > 1, metastases, no anti-neoplastic treatment, CA 125 > 35 U/mL, CYFRA 21-1 > 3.3 ng/mL and leukocytes > 10' 000/mu L, as independent prognostic factors for survival. Patients were classified into 3 groups according to the number of adverse prognostic factors (APF). One point was assigned for each APF, except for chemotherapy treatment. Patients with 0-1 APF represented our reference group: patients with 2-3 APF had HR=2.7 (95% CI: 1.5-4.6), while patients with 4-5 APF had HR=8.8 (95% CI: 4.6-16.8). This score maintained the differences between risk groups both in patients who received antineoplastic treatment and in those who did not. Conclusion: The application of a score that includes clinical data and biomarkers may improve the prognostic classification of NSCLC patients.