Lung cancer (Amsterdam, Netherlands) · 2026
Prognostic value of serum CYFRA21-1 in locally advanced non-small cell lung cancer undergoing durvalumab consolidation therapy after chemoradiotherapy.
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Ito Masahiro, Ariyasu Ryo, Fujishima Shunsuke, Iso Hirokazu, Nibuya Kyujiro, Nemoto Teruhisa, Sugai Mayu, Tsugitomi Ryosuke, Amino Yoshiaki, Uchibori Ken, Yanagitani Noriko, Nishio Makoto
Аннотация
INTRODUCTION: Chemoradiotherapy (CRT) followed by durvalumab consolidation therapy is the standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC), but robust prognostic biomarkers are lacking. This study evaluated the prognostic value of CYFRA 21-1, a serum marker associated with squamous cell carcinoma, in this setting.
METHODS: Patients with LA-NSCLC were retrospectively reviewed according to treatment (CRT plus durvalumab group vs. CRT-only group). Patients with high and normal CYFRA 21-1 levels were compared within each group, using a threshold of 3.5 ng/mL. Overall survival (OS) and real-world progression-free survival (rw-PFS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate analyses were conducted using Cox proportional hazards models.
RESULTS: There were 134 patients in the CRT plus durvalumab group and 100 patients in the CRT-only group. In the CRT plus durvalumab group, patients with high CYFRA 21-1 levels had shorter median OS versus those with normal levels (38.8 vs. 73.4 months; HR, 2.49 [95% CI, 1.31-4.72]; p < 0.05), whereas no significant difference was observed within the CRT-only group (26.2 vs. 46.5 months; HR, 1.37 [95% CI, 0.82-2.27]; p = 0.21). A similar trend in OS was observed among those with non-squamous histology. On multivariate analysis, CYFRA 21-1 emerged as an independent prognostic factor in the CRT plus durvalumab group (HR = 2.21 (95% CI: 1.10-4.44), p < 0.05). Elevated CYFRA 21-1 levels were associated with shorter rw-PFS only in the CRT plus durvalumab group.
CONCLUSION: CYFRA 21-1 may serve as a prognostic biomarker among patients with LA-NSCLC treated with CRT followed by durvalumab consolidation therapy.
METHODS: Patients with LA-NSCLC were retrospectively reviewed according to treatment (CRT plus durvalumab group vs. CRT-only group). Patients with high and normal CYFRA 21-1 levels were compared within each group, using a threshold of 3.5 ng/mL. Overall survival (OS) and real-world progression-free survival (rw-PFS) were estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate analyses were conducted using Cox proportional hazards models.
RESULTS: There were 134 patients in the CRT plus durvalumab group and 100 patients in the CRT-only group. In the CRT plus durvalumab group, patients with high CYFRA 21-1 levels had shorter median OS versus those with normal levels (38.8 vs. 73.4 months; HR, 2.49 [95% CI, 1.31-4.72]; p < 0.05), whereas no significant difference was observed within the CRT-only group (26.2 vs. 46.5 months; HR, 1.37 [95% CI, 0.82-2.27]; p = 0.21). A similar trend in OS was observed among those with non-squamous histology. On multivariate analysis, CYFRA 21-1 emerged as an independent prognostic factor in the CRT plus durvalumab group (HR = 2.21 (95% CI: 1.10-4.44), p < 0.05). Elevated CYFRA 21-1 levels were associated with shorter rw-PFS only in the CRT plus durvalumab group.
CONCLUSION: CYFRA 21-1 may serve as a prognostic biomarker among patients with LA-NSCLC treated with CRT followed by durvalumab consolidation therapy.