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

Abstract

The group with a transient elevation in CEA during adjuvant chemotherapy did not have a poorer prognosis compared with the group that had no increase in CEA. This will be further examined in a population-based New Zealand-wide study of colorectal cancer diagnosis, treatment and outcome.

Transient Changes in Serum CEA, CA19-9, CRP, YKL-40, and IL-6 during Adjuvant Chemotherapy and Survival of Patients with Colorectal Cancer

“…We used the definition of an increase of 10% from the pre-adjuvant value, in which the change was greater than the intra-assay or inter-assay variation that was observed with the methods used. With this definition, we observed a transient increase in the CEA in 46% to 71% of the patients, while Lawrence et al found a transient increase in 33% of the patients, defining the increase as twice the within-patient standard deviation [ 31 ]. An arbitrary increase or decrease of >0.5 µg/L has also been used [ 29 ], and sometimes this definition may be lacking [ 30 ].…”

“…Most evidence about CEA’s change patterns, during and after chemotherapy, comes from studies that have been carried out in mCRC, where the treatment response can be evaluated with imaging [ 24 , 25 , 26 , 27 , 28 ], which is not feasible in the adjuvant setting. Only a few studies have investigated CEA kinetics during adjuvant chemotherapy, and these have been relatively small in size, with less than 100 individuals in each study [ 29 , 30 , 31 ]. Interestingly, a transient increase in CEA may occur in some patients [ 29 , 31 ].…”

“…Only a few studies have investigated CEA kinetics during adjuvant chemotherapy, and these have been relatively small in size, with less than 100 individuals in each study [ 29 , 30 , 31 ]. Interestingly, a transient increase in CEA may occur in some patients [ 29 , 31 ]. A study with 61 patients concluded that the patients who had a transient elevation in their CEA during adjuvant chemotherapy had similar OS compared with the patients who had no CEA increase, and both groups had a more favourable survival than the patients whose CEA increased persistently (36).…”

Combination of serum lipids and cancer antigens as a novel marker for colon cancer diagnosis

“…There are several methods for colon cancer diagnosis including blood-based test [ 3 ], colonoscopy [ 4 ] and barium meal imaging [ 5 ]. Blood test profiles the diagnostic biomarkers such as serum cancer antigens [ 6 ], circulating tumor cells [ 7 ], and cell-free DNA or RNA [ 8 ]. Carcinoembryonic antigen (CEA) [ 6 ] and carbohydrate antigen 19–9 (CA 19–9) [ 9 ] are the two most-used cancer antigens for monitoring colon cancer [ 10 ].…”

“…Blood test profiles the diagnostic biomarkers such as serum cancer antigens [ 6 ], circulating tumor cells [ 7 ], and cell-free DNA or RNA [ 8 ]. Carcinoembryonic antigen (CEA) [ 6 ] and carbohydrate antigen 19–9 (CA 19–9) [ 9 ] are the two most-used cancer antigens for monitoring colon cancer [ 10 ]. Circulating tumor cells originate from the primary or metastatic sites of colon cancer, and can directly reveal the status of the disease, however, the number of circulating tumor cells is very low [ 11 ].…”