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Pro-Gastrin-Releasing Peptide (ProGRP) and Neuron Specific Enolase (NSE) inTherapy Control of Patients with Small-Cell Lung Cancer by Joachim Schneider, Monika Philipp, Lothar Salewski, Hans-Georg Velcovsky

In small-cell lung cancer patients tumor markers were used for disease monitoring. The goal of this study was to identify diagnostic efficiency in the detection of tumor behavior in small-cell lung cancer patients by using a relatively new tumor marker, ProGRP, in comparison to the established marker NSE. 34 consecutive small-cell lung cancer (SCLC) patients were included in this prospective study. The changes of the blood levels of ProGRP and NSE were compared to the clinical evaluation. Clinical monitoring was evaluated according to the standard criteria of the WHO. 19 patients had remission, 8 stable disease and 7 tumor progression under therapy. NSE and ProGRP were measured in sera before and after treatment with polychemotherapy. After tumor remission the NSE but also the ProGRP levels decreased significantly under treatment (p=0.0001 resp. p=0.0180). As suspected, pre- and post-treatment marker concentrations did not differ significantly in patients with stable disease. In progressive small-cell lung cancer patients an increase of ProGRP and NSE was detectable. Overall, a decrease of NSE was seen in 18 (95%) of all responders, while an increase during progression could be detected in 6 (86%) of the patients. Because 6 patients in remission showed an increase in ProGRP concentrations, the corresponding data are 68% in responders and also 86% in progressive SCLC-patients. In conclusion, ProGRP was helpful as a diagnostic aid for therapy control in small-cell lung cancer patients. A long-term follow-up indicated that ProGRP can be used to monitor disease either with tumor regression under therapy as well as detection of subsequent progression. ProGRP could be well suited to complete the present diagnostic panel for lung cancer.