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H. Okada
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P3.06 - Poster Session/ Screening and Early Detection (ID 220)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.06-009 - Evaluation of Bone Metastasis Using Serial Measurements of Serum NTx in Patients with Lung Cancer: A Prospective Study (ID 1648)
09:30 - 09:30 | Author(s): H. Okada
- Abstract
Background:
The bone resorption biomarkers cross-linked N-telopeptide of type I collagen (NTx) have been shown to aid in the diagnosis of metastatic bone disease from lung cancer (MBDLC). Patients with MBDLC are often treated with zoledronic acid (ZA). ZA reduces the levels of NTx and also lowers the risk of skeletal adverse events in patients with MBDLC.
Methods:
Patients with MBDLC at initial diagnosis were included in this study. Serum NTx (sNTx) was measured once a month using the OSTEOMARK[TM] sNTx assay (Alere Medical). MBDLC was assessed by monthly physical examinations and bone scintigraphy every 3 months for 12 months. Progression of bone metastases during the follow-up period was defined as when the number of bone metastases as assessed by bone scintigraphy had increased from the previous follow-up measurement. The optimal cut-off value of sNTx levels indicative of progression of bone metastasis was evaluated by performing a receiver operating characteristic (ROC) curve analysis. In this ROC analysis, we evaluated the change rate of sNTx per month. The change rate per month was defined as “The change rate of sNTx between at the minimum levels of NTx and at the worsening bone metastasis / the number of month from the minimum levels of sNTx to the worsening bone metastasis’’
Results:
Twenty patients were enrolled between June and December 2010. The sNTx concentration at baseline was 19.8 ± 5.8 nmol bone collagen equivalents (nM BCE)/L. In the 16 patients receiving ZA, the levels of sNTx showed a significant decrease after the first month of treatment (baseline vs. 1 month of treatment: 21.3 ± 5.5 vs. 13.6 ± 2.7 nM BCE/L; p < 0.01). During the follow-up period, 13 of the patients treated with ZA experienced worsening bone metastasis. There were statistically significant differences in the levels of sNTx at baseline (20.3 ± 4.8 nM BCE/L), at the lowest levels after the administration of ZA (11.8 ± 2.9 nM BCE/L vs. baseline; p < 0.001), and at the point of measurable disease progression (14.1 ± 4.6 nM BCE/L vs. baseline; p < 0.05). In the ROC analysis, the optimal change rate of sNTx per month was 4.0% (sensitivity: 53.8%, specificity: 100%, area under the curve = 0.564).
Conclusion:
The administration of ZA significantly decreased the levels of sNTx within one month of the initiation of therapy. However, the levels of sNTx was slightly elevated when the bone metastasis has been aggravated during ZA treatment. The serial measurements of sNTx might prove to be useful in selecting drug treatment and evaluating drug efficacy for bone metastasis.
