High Pretreatment Serum Concentration of Basic Fibroblast Growth Factor Is a Predictor of Poor Prognosis in Small Cell Lung Cancer1
- Departments of Internal Medicine [T. R., K. M.] and Oncology [H. J.], Helsinki University Central Hospital, FIN-00290 Helsinki, Finland, and Division of Hematology-Oncology, Weill Medical College of Cornell University, New York, New York 10021 [P. S.]
Abstract
Basic fibroblast growth factor (bFGF) is a secreted multifunctional cytokine and a potent stimulator of angiogenesis. We measured bFGF concentrations from serum samples taken from 103 patients with small cell lung cancer at the time of diagnosis. Serum concentration of bFGF (S-bFGF) ranged from undetectable to 54 pg/ml (median, 6 pg/ml). S-bFGF was not associated with age, sex, performance status, or stage. A high pretreatment S-bFGF was associated with poor overall survival. The 1- and 2-year survival rates of the patients within the highest quartile of S-bFGF (≥17 pg/ml) were only 26% and 11%, respectively, in contrast to the 49% and 20% 1- and 2-year survival rates of those patients with S-bFGF < 17 pg/ml (P = 0.013). The 1- and 2-year survival rates of the patients with extensive-stage disease were 33% and 10%, respectively (P = 0.0091). Interestingly, S-bFGF provided additional prognostic information to the stage because the 1- and 2-year survival rates of patients with extensive-stage disease and a high S-bFGF (≥17 pg/ml) were as low as 16% and 5%, respectively (P = 0.0026). Similarly, in the multivariate model of survival analysis, patients with both extensive-stage disease and a high S-bFGF (≥17 pg/ml) were found to have a particularly poor prognosis (relative risk of death, 2.1; 95% confidence interval, 1.2–3.6; P = 0.0057). We conclude that a high S-bFGF at diagnosis is associated with poor outcome in small cell lung cancer, possibly reflecting active angiogenesis and rapid tumor growth, and may complement prognostic information obtained by staging.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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↵1 Supported by grants from the Sigrid Juselius Foundation, the Finnish Medical Foundation, the Maud Kuistila Memorial Foundation, and the Ella and Georg Ehrnrooth Foundation.
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↵2 To whom requests for reprints should be addressed, at Division of Hematology-Oncology, Weill Medical College of Cornell University, 1300 York Avenue, Room C-606, New York, NY 10021. Phone: (212) 746-2017; Fax: (509) 692-0650; E-mail: pjs2004@med.cornell.edu; petri.salven{at}helsinki.fi
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↵3 The abbreviations used are: bFGF, basic fibroblast growth factor; S-bFGF, serum concentration(s) of bFGF; SCLC, small cell lung cancer; RR, relative risk; CI, confidence interval; CLL, chronic lymphocytic leukemia.
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- Accepted July 5, 1902.
- Received January 25, 1902.
- Revision received January 25, 1902.
