Prognostic significance of serum p53 antibodies in patients with limited-stage small cell lung cancer

p53 tumour suppressor gene alterations are one of the most frequent genetic events in lung cancer. A subset of patients with p53 mutation and cancer e xhibited circulating serum anti-p53 self-antibodies (p53-Ab). The prevalenc e of these antibodies in lung cancer is currently being analysed in a multi centric study. In a group of homogeneous SCLC patients, p53-Ab were detecte d in 20/97 (20.6%) individuals. In this group of patients, Cox's multivaria te analysis identified disease extent (p = 0.022), WHO initial performance status greater than 0 (p = 0.005), and the absence of a complete response a fter 6 months of treatment (p < 0.0001) as independent prognostic variables , with p53-Ab being of borderline significance (p 0.051). In the subset of limited-stage SCLC patients, Cox's multivariate analysis found p53-Ab (p = 0.033), WHO initial performance status greater than 0 (p = 0.028), and abse nce of a complete response (p < 0.001) to be independent prognostic variabl es. Thus, actuarial analysis showed that patients with limited-stage SCLC a nd p53-Ab had a median survival time of 10 months, whereas limited-stage SC LC patients without p53-Ab had a 17-month median survival time (p 0.014). T herefore, serum assay of p53-Ab could help to identify a population of SCLC patients with an especially poor prognosis. This population could represen t patients with tumours harboring aggressive p53 mutations. (C) 2000 Wiley- Liss, Inc.