Biomarkers for lung cancer

1- Currently, single tumor markers, such as CYFRA 21-1, CEA, NSE, and ProGRP should not be used for screening purposes either in asymptomatic populations or in those at high risk for lung cancer (e.g. smokers).2- Depending on histology, determination of CYFRA 21-1, CEA, NSE and/or ProGRP may be helpful in lung cancer patients prior to the first therapy. where no histology can be obtained before surgery, measurement of all four markers is necessary to identify the leading marker (usually that present in highest concentration).3- where inoperable lung cancer is suspected but no histology is available, raised serum NSE and especially ProGRP are highly suggestive of small cell lung cancer while raised serum SCCA is suggestive of squamous cell cancer.4- Follow-up of asymptomatic patients after pnmary therapy of lung cancer IS controversial. However serial determinations of the appropriate tumor marker may help to assess the completeness of tumor removal and provide early indication of recurrence.5- CEA and CYFRA 21-1 can be measured during systemic treatment of non-small cell lung cancer, NSE and ProGRP during systemic treatment of small cell lung cancer to reflect response to therapy and to document progressive disease.6- Cox-2 and EGFR is overexpressed in adenocarcinoma. MMP-2 can predict a poor post- operative survival for NSCLC. A significant elevation of serum VEGF in a small patient population with advanced NSCLC in comparison with those with early disease.