Abstract
OBJECTIVES—To follow up the level of anti-Hu antibody titres during chemotherapy and to compare the pattern of metastases and other neurological complications before and after chemotherapy in patients with small cell lung cancer (SCLC) with and without low titre anti-Hu antibodies. Seventeen per cent of patients with SCLC without paraneoplastic syndromes have a low titre of anti-Hu antibodies in their serum. Previous studies suggested that these antibodies correlate with a more indolent tumour growth. METHODS—The serum of 52 consecutive patients with SCLC were studied before and during chemotherapy, and the correlation with stage of disease and pattern of metastases was examined. All serum samples were investigated using western blot and enzyme linked immunosorbent assay (ELISA) with HuD recombinant protein. All patients with SCLC were investigated using MRI of the brain, CSF, bone marrow aspiration, ultrasound of the abdomen, and radionuclide bone scan. RESULTS—Nine (17%) of 52 SCLC serum samples were positive by western blot. At the time of diagnosis none of the anti-Hu positive patients had either CNS (brain or leptomeningeal), epidural, adrenal, or bone marrow metastases and 56% had limited disease. In eight of 43 anti-Hu negative patients CNS metastases were found at the time of diagnosis, and only 30% had limited disease. The prevalence of bone and liver metastases was similar in both groups. Survival was 11 (SD ) months for the 43 anti-Hu negative and 10 (SD 6) months for the nine anti-Hu positive patients. Male:female ratio in the anti-Hu negative group was 4.4:1, and in the anti-Hu positive group 2:1. CONCLUSIONS—No anti-Hu antibody positive serum, as tested by western blot, became negative during chemotherapy. Anti-Hu positive and anti-Hu negative patients had similar survival, but anti-Hu positive patients tended to be women, had limited disease at the time of tumour diagnosis, and initially metastases seemed to spare the nervous system.
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- Dalmau J., Furneaux H. M., Gralla R. J., Kris M. G., Posner J. B. Detection of the anti-Hu antibody in the serum of patients with small cell lung cancer--a quantitative western blot analysis. Ann Neurol. 1990 May;27(5):544–552. doi: 10.1002/ana.410270515. [DOI] [PubMed] [Google Scholar]
- Dalmau J., Graus F., Rosenblum M. K., Posner J. B. Anti-Hu--associated paraneoplastic encephalomyelitis/sensory neuronopathy. A clinical study of 71 patients. Medicine (Baltimore) 1992 Mar;71(2):59–72. doi: 10.1097/00005792-199203000-00001. [DOI] [PubMed] [Google Scholar]
- Graus F., Dalmou J., Reñ R., Tora M., Malats N., Verschuuren J. J., Cardenal F., Viñolas N., Garcia del Muro J., Vadell C. Anti-Hu antibodies in patients with small-cell lung cancer: association with complete response to therapy and improved survival. J Clin Oncol. 1997 Aug;15(8):2866–2872. doi: 10.1200/JCO.1997.15.8.2866. [DOI] [PubMed] [Google Scholar]
- Graus Y. F., Verschuuren J. J., Degenhardt A., van Breda Vriesman P. J., De Baets M. H., Posner J. B., Burton D. R., Dalmau J. Selection of recombinant anti-HuD Fab fragments from a phage display antibody library of a lung cancer patient with paraneoplastic encephalomyelitis. J Neuroimmunol. 1998 Mar 1;82(2):200–209. doi: 10.1016/s0165-5728(97)00199-9. [DOI] [PubMed] [Google Scholar]
- Spiegelman D., Maurer L. H., Ware J. H., Perry M. C., Chahinian A. P., Comis R., Eaton W., Zimmer B., Green M. Prognostic factors in small-cell carcinoma of the lung: an analysis of 1,521 patients. J Clin Oncol. 1989 Mar;7(3):344–354. doi: 10.1200/JCO.1989.7.3.344. [DOI] [PubMed] [Google Scholar]
- Winter S. F., Sekido Y., Minna J. D., McIntire D., Johnson B. E., Gazdar A. F., Carbone D. P. Antibodies against autologous tumor cell proteins in patients with small-cell lung cancer: association with improved survival. J Natl Cancer Inst. 1993 Dec 15;85(24):2012–2018. doi: 10.1093/jnci/85.24.2012. [DOI] [PubMed] [Google Scholar]
- Wolf M., Holle R., Hans K., Drings P., Havemann K. Analysis of prognostic factors in 766 patients with small cell lung cancer (SCLC): the role of sex as a predictor for survival. Br J Cancer. 1991 Jun;63(6):986–992. doi: 10.1038/bjc.1991.215. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zamora P. O., Bender H., Gulhke S., Marek M. J., Knapp F. F., Jr, Rhodes B. A., Biersack H. J. Pre-clinical experience with Re-188-RC-160, a radiolabeled somatostatin analog for use in peptide-targeted radiotherapy. Anticancer Res. 1997 May-Jun;17(3B):1803–1808. [PubMed] [Google Scholar]
- de la Monte S. M., Hutchins G. M., Moore G. W. Paraneoplastic syndromes and constitutional symptoms in prediction of metastatic behavior of small cell carcinoma of the lung. Am J Med. 1984 Nov;77(5):851–857. doi: 10.1016/0002-9343(84)90523-0. [DOI] [PubMed] [Google Scholar]