ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1561602
This article is part of the Research TopicPrecision Oncology in Checkpoint Immunotherapy: Leveraging Predictive Biomarkers for Personalized TreatmentView all 24 articles
Predictive Value of Early Changes in Serum CEA, CYFRA21-1, and SCC-Ag for Efficacy and Prognosis in Advanced Lung Squamous Cell Carcinoma Treated with First-Line Immunotherapy Combined with Chemotherapy
Provisionally accepted
Xinyi HUANG1,2
Chuanpeng HU2*- 1Department of Clinical Medicine, Bengbu Medical College, Bengbu, China
- 2Lu’an Hospital, Anhui Medical University, Hefei, Anhui Province, China
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Objective This study aimed to investigate the association between early changes in serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and squamous cell carcinoma antigen (SCC-Ag) levels with treatment response and survival outcomes in patients with advanced lung squamous cell carcinoma(LUSC) receiving first-line immunotherapy combined with chemotherapy (hereinafter referred to as first-line IO-chemo), so as to identify potential biomarkers for predicting benefit from first-line IO-chemo. Methods A retrospective analysis was conducted on 89 patients with advanced LUSC who received first-line IO-chemo. Serum levels of CEA, CYFRA21-1, and SCC-Ag were measured before initiation of IO-chemo and before the third treatment cycle. Rate of change was calculated for each marker. Predictive performance for treatment response was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). Progression-free survival (PFS) was analyzed by Kaplan-Meier method with log-rank test, and independent prognostic factors were identified using Cox proportional hazards regression. Results In 89 patients with advanced LUSC receiving first-line IO-chemo, early declines in CYFRA21-1 and SCC-Ag were significantly associated with improved efficacy and prognosis. The median progression-free survival (mPFS) was 6.7 months. Patients with CYFRA21-1 reduction ≥19.5% had longer mPFS (7.6 vs. 5.5 months, P=0.032), as did those with SCC-Ag reduction ≥13.5% (7.5 vs. 5.9 months, P=0.014). Multivariate analysis confirmed that greater reductions in both markers were independent predictors of favorable PFS. Conclusion Early changes in CYFRA21-1 and SCC-Ag levels may serve as valuable biomarkers for predicting treatment response and survival outcomes in patients with advanced LUSC undergoing first-line IO-chemo.
Keywords: Advanced Lung Squamous Cell Carcinoma 1, tumor markers 2, Immuno-Chemotherapy 3, tumor response 4, survival time 5
Received: 16 Jan 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 HUANG and HU. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chuanpeng HU, 343013230@qq.com
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