Carcinoembryonic antigen surge in metastatic colorectal cancer patients responding to irinotecan combination chemotherapy

Abstract

A CEA surge can be induced by irinotecan-based chemotherapy. An early increase in CEA after irinotecan-based chemotherapy does not usually indicate progression of disease and failure of therapy, and should not lead to a change of chemotherapy.

Clinical significance of a serum CA 15-3 surge and the usefulness of CA 15-3 kinetics in monitoring chemotherapy response in patients with metastatic breast cancer

“…PSA surge in prostatic cancer and AFP surge in germ cell tumor originally suggest universal ''flare-up'' from acute cell lysis irrespective of tumor burden [11][12][13][14][15]. For CEA surge, it is usually reported to be related with chemotherapeutic agents, especially for 5-FU [16,17]. Our experience suggests that surge of CA 15-3 in MBC may be related with high tumor burden and molecular subtype as well as acute tumor cell destruction due to chemotherapy [1].…”

Un « effet-pointe » troublant sur l’hCG dosé au cours de la chimiothérapie de rattrapage d’une tumeur trophoblastique chez une jeune femme

“…L'auteur propose une définition de l'effet-pointe basée sur une augmentation de la concentration sérique du marqueur, au-delà de 20 % de la valeur basale mesurée 15 jours avant le début de la chimiothérapie, suivie d'une diminution jusqu'à un taux inférieur de 20 % à la ligne de base. Ce phénomène est également décrit [15,16] chez des patients traités par chimiothérapie à base d'irinotécan. L'effet-pointe de l'ACE survient tardivement (médiane : quatre semaines) et peut se prolonger jusqu'à 11 semaines [15].…”

“…L'incidence d'effetspointe de l'antigène spécifique de prostate (PSA) est estimée entre 7,3 et 20 % [16,17]. Un effet-pointe peut également être observé en deuxième ligne de chimiothé-rapie [18].…”

Transient elevation in serum carcinoembryonic antigen while on adjuvant chemotherapy for colon cancer: Is this of prognostic importance?

“…The half‐life of serum CEA is between 3 and 13 days, and it is primarily metabolized by the liver . Eighty‐five percent of the population has a level of <2.5 μg/L, and 95% has a level of <5 μg/L . Its use in early stage colorectal cancer is limited due to its poor sensitivity as a diagnostic tool, as serum CEA can be raised in a variety of nonmalignant conditions including chronic liver disease and inflammatory bowel conditions, as well as small rises being attributable to smoking .…”

“…It is well described in the metastatic setting that repeated measurements of serum CEA can be used to monitor response to treatment, with an expected decrease in levels if patients are responding or have had surgical resection of their tumor, and a rise potentially indicating progression of the cancer . In addition, several studies have reported that 10–15% of patients with metastatic colorectal cancer experience a transient elevation in serum CEA, defined as rise and fall of 15–20% from baseline at the initiation of either oxaliplatin‐ or irinotecan‐based chemotherapy. This occurs around 2–4 weeks after the initiation of chemotherapy, and can last for up to 12 weeks .…”