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document
Changes of activated circulating endothelial cells and survivin in patients with non-small cell lung cancer after antiangiogenesis therapy . BACKGROUND Although antiangiogenesis therapy plays an important role in anti-neoplastic treatment with its recognized efficacy and slight adverse effect , there is no prospective clinical trial to define ideal markers for predicting efficacy of antiangiogenic therapy . This study was undertaken to investigate the changes of activated circulating endothelial cells ( aCECs ) and survivin after anti-angiogenesis therapy and their significance in predicting the efficacy of the therapy . METHODS Patients of non-small cell lung cancer ( NSCLC ) treated with chemotherapy with or without Endostar were observed . The amount of activated CECs was detected by flow cytometry , and the expression of survivin mRNA was determined by real-time polymerase chain reaction ( PCR ) . RESULTS After treatment , the amount of activated CECs decreased significantly in clinical benefit cases ( P = 0.021 in chemotherapy alone , P = 0.001 in chemotherapy plus Endostar ) , increased in disease progressive cases ( P = 0.015 in chemotherapy alone , but P = 0.293 in chemotherapy with Endotatar ) . After therapy , the expression of survivin mRNA decreased in clinical benefit cases ( P = 0.001 ) and increased in disease progressive cases ( P = 0.018 ) . A positive correlation was found between activated CECs and survivin in the chemotherapy group pre- and post-therapy ( P = 0.001 and 0.021 , respectively ) , but only in the chemotherapy with Endostar group pre-therapy ( P = 0.030 ) rather than post-therapy . A positive correlation was found between the decreased activated CECs after therapy and time to progression ( TTP ) ( r = 0.322 , P = 0.012 ) ; a negative correlation was found between the amount of survivin mRNA in serum post-therapy and TTP ( r = -0.291 , P = 0.048 ) . CONCLUSIONS Activated CECs and survivin may be ideal markers forecasting efficacy and prognosis of NSCLC . The former can reflect more sensitively antiangiogenic efficacy and the latter is more sensitive to shrinkage or swelling of tumors . Their combination can evaluate more accurately the efficacy of antiangiogenic therapy of NSCLC .
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Intervention_Pharmacological
antiangiogenesis therapy
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Intervention_Pharmacological
antiangiogenesis therapy
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Intervention_Control
anti-neoplastic treatment
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Intervention_Physical
antiangiogenic therapy
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Intervention_Pharmacological
chemotherapy with or without Endostar
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Intervention_Physical
chemotherapy
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Intervention_Physical
chemotherapy plus Endostar
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Intervention_Physical
chemotherapy
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Intervention_Physical
chemotherapy with Endotatar
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Intervention_Physical
chemotherapy
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Intervention_Physical
chemotherapy with Endostar
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Intervention_Physical
antiangiogenic therapy
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Outcome_Physical
activated CECs
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Outcome_Physical
disease progressive cases
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Outcome_Physical
expression of survivin mRNA
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Outcome_Physical
disease progressive cases
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Outcome_Physical
activated CECs
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Outcome_Physical
activated CECs
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Outcome_Physical
time to progression ( TTP )
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Outcome_Physical
amount of survivin mRNA in serum post-therapy and TTP