CA 19-9 tumour-marker response to chemotherapy in patients with advanced pancreatic cancer enrolled in a randomised controlled trial

Hess, Viviane; Glimelius, Bengt; Grawe, Philipp; Dietrich, Daniel; Bodoky, G.; Ruhstaller, Thomas; Bajetta, Emilio; Saletti, Piercarlo; Figer, Arié; Scheithauer, Werner; Herrmann, Richard

doi:10.1016/s1470-2045(08)70001-9

Cited by 213 publications

(178 citation statements)

References 20 publications

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“…For preoperative assessment of tumor extension, tumor markers such as a serum CA19-9 level have been used in biliary and pancreas carcinomas [23,24]. The diagnosis of lymph node metastasis using this marker alone is almost impossible.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Diagnosis of Lymph Node Metastasis in Biliary and Pancreatic Carcinomas: Evaluation of the Combination of Multi-detector CT and Serum CA19-9 Level

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Preoperative Diagnosis of Lymph Node Metastasis in Biliary and Pancreatic Carcinomas: Evaluation of the Combination of Multi-detector CT and Serum CA19-9 Level

et al. 2010

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“…Whether serum CA 19-9 levels can be used as a surrogate marker of response to chemotherapy has been studied in a variety of clinical settings [41,44,[53][54][55][56][57][58][59][60][61][62][63][64]. Willett et al measured CA 19-9 serum levels in 42 resectable pancreatic cancer patients receiving neoadjuvant treatment with 5-flourouracil and external beam radiation prior to planned pancreaticoduodenectomy.…”

Section: Ca 19-9 Serum Levels As a Biomarker For Chemotherapy Responsmentioning

confidence: 99%

“…Nearly all studies have demonstrated that a treatment related decline in CA 19-9 serum levels is associated with prolonged survival and is an independent predictor of overall survival [41,44,[53][54][55][56][57][58][59][60][61][62][63][64] (Table 5). Reni et al compared basal CA 19-9 serum levels in 247 advanced pancreatic cancer patients enrolled in five consecutive chemotherapy trials (G, gemcitabine; PEFG, cisplatin, epirubicin, 5-fluorouracil, and gemcitabine; PDXG, cisplatin, docetaxel, capecitabine, and gemcitabine) [60].…”

Section: Ca 19-9 Serum Levels As a Biomarker For Chemotherapy Responsmentioning

confidence: 99%

Serum CA 19-9 as a Biomarker for Pancreatic Cancer—A Comprehensive Review

Ballehaninna

Chamberlain

2011

Indian J Surg Oncol

213

161

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“…The National Comprehensive Cancer Network recommends measurement of serum CA 19-9 level following surgery prior to the administration of adjuvant therapy. Although initial CA 19-9 levels have been shown to correlate with survival in patients with LAPC or metastatic disease, there is conflicting evidence regarding the predictive value of peri-treatment CA 19-9 levels in patients with LAPC treated with radiotherapy or chemotherapy (5)(6)(7)(8). In patients who receive chemoradiation for LAPC, data is limited regarding the prognostic significance of peri-treatment CA 19-9 (9-11).…”

Section: Introductionmentioning

confidence: 99%

Change in CA 19-9 Levels after Chemoradiotherapy Predicts Survival in Patients with Locally Advanced Unresectable Pancreatic Cancer

Yang

Malik

Chandrasekhar

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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.Purpose: RTOG 9704 demonstrated a prognostic role for postoperative CA 19-9 in patients with resectable pancreatic carcinoma following surgery. Our study aimed to investigate whether CA 19-9 provided similar prognostic information in patients with locally advanced unresectable pancreatic cancer (LAPC) treated with chemoradiotherapy (CRT) and to determine whether such endpoints should therefore be reported in future randomized trials. Only patients with a bilirubin of less than 2 mg/dL at the time the CA 19-9 was evaluated were included in the analysis to avoid the confounding effect of hyperbilirubinemia. Of the eligible patients, 54 had pre and post CRT CA 19-9 values available. The median age was 68 years and 52% were female. Categorized versions of the first post-CRT CA 19-9 were tested in 50 point increments beginning at <50 to >1,000 and percent change in pre to post-CRT CA 19-9 using cut points of 10% increments from <0% (increased) to >90%. Survival was measured from the date of first post CRT CA 19-9 level until death or last follow-up.Univariate and multivariate statistical methodologies were used to determine significant prognostic factors for overall survival.Results: Median CA 19-9 prior to CRT was 363 U/mL and post CRT median was 85.5 U/mL. Following CRT, patients with a decrease of >90% from their baseline CA 19-9 level had a significantly improved median survival than those that did not (16.2 vs. 7.5 months, P=0.01). The median survival of patients with a CA 19-9 level lower than the median post CRT value was 10.3 months, compared with 7.1 months for those with a CA 19-9 level greater than the median (P=0.03). Post CRT CA 19-9 less than 50 U/mL and histologic grade I-II also showed prognostic significance (both P=0.03). In multivariate analysis, post CRT CA 19-9 less than the median level of 85.5 U/mL was an independent prognostic factor for overall survival (HR 0.34; 95% CI, 0.13-0.85, P=0.02). Conclusions:Our results indicate that post treatment CA 19-9 is predictive for overall survival in patient with LAPC following CRT. We recommend that pre and post treatment CA 19-9 levels be obtained in patients receiving CRT and that these values be considered for prognostic nomograms and future clinical trials.

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CA 19-9 tumour-marker response to chemotherapy in patients with advanced pancreatic cancer enrolled in a randomised controlled trial

Cited by 213 publications

References 20 publications

Preoperative Diagnosis of Lymph Node Metastasis in Biliary and Pancreatic Carcinomas: Evaluation of the Combination of Multi-detector CT and Serum CA19-9 Level

Preoperative Diagnosis of Lymph Node Metastasis in Biliary and Pancreatic Carcinomas: Evaluation of the Combination of Multi-detector CT and Serum CA19-9 Level

Serum CA 19-9 as a Biomarker for Pancreatic Cancer—A Comprehensive Review

Change in CA 19-9 Levels after Chemoradiotherapy Predicts Survival in Patients with Locally Advanced Unresectable Pancreatic Cancer

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