Predictive and prognostic significance of neuron-specific enolase (NSE) in non-small cell lung cancer

Background: The predictive and prognostic role of neuron-specific enolase (NSE) in non-small cell lung cancer (NSCLC) is still under debate. Patients and Methods: To study these aspects, serum NSE was prospectively measured at baseline of first-line chemotherapy treatment and tested for correlation with clinical outcome in 129 advanced NSCLC patients. Results: An objective response was achieved in 27 out of 65 (41.5%) patients with NSE <8.6 ng/ml and in 38 out of 64 (59.4%) patients with NSE ≥8.6 ng/ml (p=0.05). Logistic analysis confirmed the positive association between objective response and NSE values ≥8.6 ng/ml (odds ratio=1.69; 95% confidence interval: 1.09-2.63; p=0.02). Overall median survival was 10.8 months. A statistically significant prognostic effect on survival was found for performance status, stage and response to treatment, but not for baseline NSE value. Conclusion: Based on these data, baseline circulating tumor NSE levels appear to have a weak predictive role, but not a prognostic significance in patients with advanced NSCLC submitted to standard chemotherapy.