CA19-9 as a predictor of tumor response and survival in patients with advanced pancreatic cancer treated with gemcitabine based chemotherapy.

Abstract

AIMS:

The aim of this study was to determine the predictive role of pretreatment carbohydrate antigen 19-9 (CA19-9) measurement and its change after one cycle of gemcitabine-based therapy for response, time to progression (TTP) and overall survival (OS).

METHODS:

Analyses were derived from three consecutive gemcitabine-containing phase II clinical trials between 1997 and 2004.

RESULTS:

A total of 111 patients with pancreas cancer was studied. Baseline CA19-9 concentrations were dichotomized near the median. Lower baseline CA19-9 levels were positively associated with OS (median 9.1 vs 6.1 months, P = 0.0057) and TTP (median 6.4 vs 4.2 months, P = 0.0044).The covariate adjusted hazard ratio (HR) for progression among patients with baseline CA19-9 >or= 1000 ng/mL was HR = 1.94 (95% CI 1.24-3.02), with P = 0.0035. The covariate adjusted risk of death among patients with baseline CA19-9 >or= 1000 ng/ml was similarly elevated: HR = 1.90 (95% CI 1.23-2.94), with P = 0.0039. Change in CA19-9 levels from baseline to the end of treatment cycle 1 did not predict objective response (P = 0.75). There was somewhat longer OS (median 8.7 vs 7.1 months) and TTP (median 7.1 vs 5.4 months) in patients with >or=50% reduction in serum CA19-9 concentrations, but this was not statistically significant (P = 0.74 and 0.81, respectively).

CONCLUSION:

Baseline CA19-9 levels may predict survival in patients with advanced pancreas cancer. The change in CA19-9 levels determined within 1 month of the initiation of therapy did not predict treatment outcome.

• Authors: Nazik Hammad, Lance K Heilbrun, Philip A Philip, Anthony F Shields, Mark M Zalupski, Raghu Venkatramanamoorthy, Bassel F El-Rayes
• Journal: Asia-Pacific journal of clinical oncology (Asia Pac J Clin Oncol) Vol. 6 Issue 2 Pg. 98-105 (Jun 2010) ISSN: 1743-7563 [Electronic] Australia
• PMID: 20565421 (Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• CA-19-9 Antigen
• Deoxycytidine
• Gemcitabine

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• CA-19-9 Antigen (blood)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Disease Progression
• Female
• Humans
• Male
• Middle Aged
• Pancreatic Neoplasms (blood, drug therapy, pathology)
• Prognosis
• Prospective Studies
• Survival Analysis
• Treatment Outcome
• Gemcitabine