Ability of CEA blood levels to reflect tumour burden: a study in a human xenograft model

Quayle, J B

doi:10.1038/bjc.1982.187

Cited by 16 publications

(5 citation statements)

References 28 publications

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“…These findings are consistent with previous studies at least as regards TPA and CEA (Luthgens & Schlegel, 1981;Skryten et al, 1981;Biorklund, 1983;Quayle, 1982) and suggest that TPA is related to tumoral proliferation while CA15-3 and CEA are tumour mass related antigens. In conclusion, data from this study indicate that in the post-operative follow-up of breast cancer patients, TPA is the most useful of the three tumour markers and CA15-3 TPA is the most suitable combination.…”

Section: Discussionsupporting

confidence: 82%

Evaluation of serum CA15-3 determination with CEA and TPA in the post-operative follow-up of breast cancer patients

Nicolini

Colombini²,

Luciani³

et al. 1991

Br J Cancer

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Summary The usefulness of post-operatively serial serum CA15-3 determination with CEA and TPA was evaluated in a group of 285 breast cancer patients. In particular, the CAI 5-3 sensitivity to 'early' diagnosis and monitoring of the response to treatment of breast cancer relapses, was compared with those of the two other markers in order to'define the most suitable association. Moreover, in a group of 169 non relapsed patients with a prolonged follow-up (40±8 months; mean±s.d.) CA15-3 specificity was investigated.During post-operative follow-up in 27 (10%) patients, distant metastases occurred. In most of them, elevated values of one or more tumour markers were the first pathological sign and CA15-3, CEA and TPA sensitivity to 'early' diagnosis of metastases were 46%, 7% and 63% respectively. When each tumour marker was considered in combination, CA15-3-CEA-TPA association showed a higher sensitivity (87%) than both CA15-3-TPA (83%) and the CEA-TPA (70%). Serum CA15-3 increase preceded the certain sign of metastases 2.7 ± 2.6 months (mean ± s.d. In our previous study (Nicolini et al., 1989) we showed that their serial serum determinations with contemporaneous urinary hydroxyproline-creatinine ratio (OHP/Cr) measurement (the latter as a bone tissue marker) provide guidelines for a rational post-operative follow-up of breast cancer patients. In fact, in most patients, high values of these tumour markers were the first sign of relapse; furthermore, they are easily repeatable and harmless examinations. More recently, a new antigenic determinant defined by two monoclonal antibodies (115 D8 and DF3), has been found in blood of patients with breast cancer. Thus, an immunoradiometric assay (IRMA), has been developed with these two MAbs to measure the breast cancer associated antigen 115 D8/DF3 (CA15-3).So far, the collected data also suggest that this tumour marker is not useful for the diagnosis of the primary tumour (Gion et al., 1986;Schmidt-Rhode et al., 1987). Moreover, they indicate that this new marker correlates with the stage of disease and in metastatic patients with the response to treatment (Colomer et al., 1986;Hilkens et al., 1984;Omar et al., 1988).Nevertheless, there are insufficient data to define whether this marker is advisable for use with or in place of the more commonly used markers for the post-operative follow-up of breast cancer patients.In our Center since 1985, all breast cancer patients followed-up with CEA and TPA have also been followed with serial serum CA15-3 determinations.The prolonged period of observation and the large number of patients studied allowed us to evaluate the usefulness of serum CA15-3 measurement in 'early diagnosis' and in the monitoring of response to therapy of breast cancer relapses. Moreover, these findings were compared with those of CEA and TPA to define the most suitable association of these three tumour markers. Materials and methods PatientsSince June 1985 until September 1989, 285 breast cancer patients, aged 29 to 84 years, followed-up post-operatively with se...

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Section: Discussionsupporting

confidence: 82%

Evaluation of serum CA15-3 determination with CEA and TPA in the post-operative follow-up of breast cancer patients

Nicolini

Colombini²,

Luciani³

et al. 1991

Br J Cancer

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“…These consisted of 4 colorectal (HK1,6,7,9), one breast (S32) and one lung (p246) tumours. Their characteristics, and the techniques of immune-deprivation, grafting and tumour measurement, together with methods for measuring circulation CEA levels have previously been described in the preceding article (Quayle, 1982 The results are illustrated in Fig. 1.…”

Section: Methodsmentioning

confidence: 69%

Tumour lysis as a factor affecting blood levels of CEA

Quayle¹

1982

Br J Cancer

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A hypothesis is proposed that tumour lysis may be an important factor affecting blood levels of CEA. This has been explored in an experimental study with a model tumour system, consisting of immune-deprived mice bearing human CEA-producing tumours. Using agents such as irradiation, chemotherapeutic drugs, diphtheria toxin and techniques such as cryosurgery, it has been shown that tumour lysis is important when it is both rapid and extensive. The extent to which this may occur in patients remains uncertain, except in rare instances of dramatic response of malignant disease to treatment.

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“…www.nature.com/scientificreports/ Notably, in this regard, the original FIRE-3 study demonstrated that more patients treated with cetuximab experienced an early tumor shrinkage (68%) than those treated with bevacizumab (49%) 18 . Considering that CEA reflects the tumor burden in mCRC 6 , we speculate that an increased CEA response may be a reflection of tumor shrinkage and a greater depth of response (DpR) in patients receiving an anti-EGFR mAb regimen than in those receiving an anti-VEGF mAb treatment. The DpR is a recently proposed efficacy outcome that is defined as the percentage of tumor shrinkage observed at the nadir compared with the baseline 19 , and an increased DpR www.nature.com/scientificreports/ is regarded as a good prognostic marker for survival outcomes [20][21][22] .…”

Section: Discussionmentioning

confidence: 99%

“…In real-world clinical practice, it is important for medical oncologists to define whether the cancer is progressive or not during systemic chemotherapy for optimizing the treatment. Since changes in the CEA level may reflect tumor burden 6 , 7 , several previous studies of CRC have reported a correlation between changes in CEA level and disease response, suggesting that changes in CEA level may be a good surrogate marker for predicting disease response during systemic chemotherapy 8 – 14 . However, most of those studies had a limited sample size, and most of the included patients were treated with chemotherapy alone.…”

Section: Introductionmentioning

confidence: 99%

“…CEA has a unique advantage compared with ctDNA in terms of its inexpensive cost and reduced time required to wait for results, and it is the marker of choice for postoperative surveillance and monitoring disease response during systemic chemotherapy in CRC [2][3][4][5] .In real-world clinical practice, it is important for medical oncologists to define whether the cancer is progressive or not during systemic chemotherapy for optimizing the treatment. Since changes in the CEA level may reflect tumor burden 6,7 , several previous studies of CRC have reported a correlation between changes in CEA level and disease response, suggesting that changes in CEA level may be a good surrogate marker for predicting disease response during systemic chemotherapy 8-14 . However, most of those studies had a limited sample size, and most of the included patients were treated with chemotherapy alone.Currently, anti-vascular endothelial growth factor (VEGF) monoclonal antibody (mAb) and anti-epidermal growth factor receptor (EGFR) mAb are recommended by both the National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) guidelines as part of the first-line systemic…”

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confidence: 99%

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CEA dynamics for predicting response after anti-EGFR monoclonal antibody treatment in metastatic colorectal cancer

Kang

Kim

Hong

et al. 2023

Sci Rep

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Carcinoembryonic antigen (CEA) is the most widely used tumor marker in metastatic colorectal cancer (mCRC). However, its potential as a predictive marker of progression in mCRC during systemic chemotherapy, particularly in patients receiving monoclonal antibodies as a combination therapy, has remained of interest. Herein, we investigated whether CEA changes could predict disease progression and clinical outcomes in patients with mCRC cotreated with systemic chemotherapy and/or biologic agents. A total of 1261 patients with mCRC undergoing a first-line systemic treatment were included in this retrospective study. We analyzed the optimal cut-off value for CEA changes to predict progression at the first response evaluation by the treatment arm (chemotherapy alone, chemotherapy plus anti-vascular endothelial growth factor (VEGF) monoclonal antibody [mAb], and chemotherapy plus anti-epidermal growth factor receptor [EGFR] mAb). These cut-off values were then used to predict overall survival (OS) and progression-free survival (PFS). When stratified by their treatment arm, 891 (70.6%), 266 (21.0%), and 104 (8.2%) of the study patients were included in the chemotherapy alone-, anti-VEGF mAb, and anti-EGFR mAb groups, respectively. The optimal CEA cut-off values were 16.5% and 38.9% increase in the whole cohort and anti-EGFR mAb group, respectively, and these values showed high sensitivity and specificity for predicting disease progression. The patients in the entire population and anti-EGFR mAb group with CEA changes below these cut-off values showed significantly better OS and PFS outcomes compared those whose changes were above cut-off values. Among the patients with mCRC treated with anti-VEGF mAb, no associations were found between OS or PFS outcomes and CEA changes. CEA is potentially a good surrogate marker for predicting disease progression and survival outcomes in patients with mCRC receiving first-line systemic chemotherapy alone or chemotherapy with anti-EGFR mAb, whereas it is less effective in those treated with anti-VEGF mAb.

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Ability of CEA blood levels to reflect tumour burden: a study in a human xenograft model

Cited by 16 publications

References 28 publications

Evaluation of serum CA15-3 determination with CEA and TPA in the post-operative follow-up of breast cancer patients

Evaluation of serum CA15-3 determination with CEA and TPA in the post-operative follow-up of breast cancer patients

Tumour lysis as a factor affecting blood levels of CEA

CEA dynamics for predicting response after anti-EGFR monoclonal antibody treatment in metastatic colorectal cancer

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