Serum levels of apoptosis biomarkers, survivin and TNF-alpha in nonsmall cell lung cancer

Context: This study was conducted to investigate the prognostic role and the effects of chemotherapy on serum apoptosis biomarkers consisting of survivin and tumor necrosis factor alpha (TNF-alpha) in patients with advanced stage nonsmall cell lung cancer (NSCLC). Materials and methods: Fifty-seven patients with newly diagnosed NSCLC were enrolled into study. Performance status was 0 or 1 in 47 patients and 2 in 10 patients. Thirty-two of them were no or less than 10% weight toss. Patients were treated with platinum-based chemotherapy. Serum levels of TNF-atpha and survivin were determined by enzyme-linked immunosorbent assay (ELISA) technique. Results: White serum survivin levels in patients were not significantly different from controls (p = 0.321), serum TNF-alpha levels in patients were found significantly higher than in controls (p = 0.029). We found that serum TNF-alpha levels were increased (p < 0.001), whereas serum levels of survivin (p = 0.025) were decreased by the chemotherapy effects. The changes of the TNF-alpha and survivin serum levels due to chemotherapy effect showed a significant negative correlation (r = -0.36 p = 0.007). The increase of serum TNF-alpha levels was independent from chemotherapy response; however, the reduction of serum survivin levels was found only significant in the chemoresponsive group (p=0.039). White older age, weight loss and performance status yielded prognostic value, neither TNF-alpha nor survivin levels proved to be significant for survival. Conclusion: Our findings suggest that the reduction in the serum survivin levels of advanced NSCLC patients after chemotherapy can be used as a predictor of response to the chemotherapy but not that of survival. (C) 2007 Elsevier Ireland Ltd. All rights reserved.