Testing
Low pretreatment Lp(a) predicts EGFR mutations and shorter progression-free survival in 338 lung adenocarcinoma patients on EGFR-TKI therapy (Int J Gen Med 2024)
Original title: Pretreatment Lipoprotein(a) as a Biomarker for EGFR Mutation and Prognosis in Lung Adenocarcinoma
In a retrospective study of 338 patients with advanced lung adenocarcinoma treated with EGFR tyrosine kinase inhibitors, an optimal pretreatment Lp(a) cutoff of 20.48 mg/L was used to define high and low groups. The EGFR mutation rate was lower in the high-Lp(a) group than the low-Lp(a) group (48.0% vs 65.5%, P=0.001), and Lp(a) was an independent predictor of EGFR mutation (OR 0.41, 95% CI 0.25-0.66, P<0.001). Median progression-free survival was longer with high Lp(a) than low Lp(a) (16.1 vs 9.6 months, P=0.015), and Lp(a) independently predicted progression-free survival (HR 0.42, 95% CI 0.26-0.68, P<0.001). The findings suggest pretreatment Lp(a) could serve as an accessible biomarker for EGFR mutation status and prognosis in this cancer population, an unconventional application of a cardiovascular risk marker.
Original abstract
Purpose: This study aims to investigate the correlation between pretreatment serum lipoprotein(a) [Lp(a)] and epidermal growth factor receptor (EGFR) gene mutations, as well as its predictive value for progression-free survival (PFS) in advanced lung adenocarcinoma patients receiving epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) therapy.
Patients And Methods: We determined the optimal cutoff value for Lp(a) by receiver operating characteristic (ROC) curves and Youden's index to categorize Lp(a) into high and low groups. Logistic regression was used to analyze the EGFR mutation rate in different groups. Additionally, the relationship between pretreatment Lp(a) levels and prognostic PFS in patients with advanced (TNM stage IIIB-IV) lung adenocarcinoma treated with EGFR-TKIs was retrospectively analyzed by Cox regression, survival and stratified analysis methods.
Results: We included 338 advanced lung adenocarcinoma patients, with median age of 64 years, and slightly more female patients (51.8%), most of whom had no smoking history (70.7%), no history of chronic lung disease (87.9%), and stage IV (81.1%) patients. The EGFR gene mutation rate was 55.3% and 123 patients were included in the prognostic evaluation through screening. The optimal cutoff value for Lp(a) was 20.48 mg/L. The mutation rate in the high Lp(a) group was significantly lower than the low Lp(a) group (48.0% vs 65.5%, p = 0.001). Multivariate logistic regression analysis indicated that Lp(a) is an independent predictor of EGFR mutations (OR = 0.41, 95% CI: 0.25-0.66, p<0.001). Survival analysis showed that the median PFS was significantly longer in the high Lp(a) level group compared to the low level group (16.1 months, 95% CI: 11.9-23.8 months vs 9.6 months, 95% CI: 8.9-13.3 months, p=0.015). Multivariate analysis confirmed that Lp(a) is an independent predictor of PFS in advanced lung adenocarcinoma patients receiving EGFR-TKIs treatment (HR = 0.42, 95% CI: 0.26-0.68, p<0.001).
Conclusion: Pretreatment Lp(a) may be a biomarker for EGFR mutations and the PFS in advanced lung adenocarcinoma patients undergoing EGFR-TKIs treatment.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.