Non-small-cell lung cancer (NSCLC) is the most common cause of cancer death in North America and Western Europe. Most patients present with advanced inoperable disease; the prognosis of these patients is extremely poor. In selected patients, platinum-based regimens have been shown to have a beneficial but modest impact on survival (Klastersky and Paesmans, 2001). Conventionally, the selection of patients for chemotherapy has been based on clinico-pathological criteria, including age, stage and performance status (Numico et al, 2001).
There is increasing evidence that the presence of a systemic inflammatory response, as evidenced by elevated circulating concentrations of C-reactive protein concentrations, is associated with early recurrence and poor survival, independent of stage, in a variety of common solid tumours (Ikeda et al, 2003; McMillan et al, 2003). In advanced disease, an elevated C-reactive protein has also been shown to associated with poor survival (O’Gorman et al, 2000; Mahmoud and Rivera, 2002).
Furthermore, in an unselected cohort of patients with inoperable NSCLC, the Glasgow Prognostic Score (GPS), a cumulative prognostic score based on C-reactive protein and albumin, had similar prognostic value to that of stage and performance status (Forrest et al, 2003). The question of whether the GPS would be useful in the selection of appropriate treatment for patients with inoperable NSCLC remains to be determined.
The aim of the present study was to assess the value of the GPS in patients receiving chemotherapy for inoperable NSCLC.