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Multianimal Magnetic Resonance Imaging for Tumor Measurements in Pancreatic Cancer Mouse Models
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CA 19-9 tumour-marker response to chemotherapy in patients with advanced pancreatic cancer enrolled in a randomised

Viviane Hess1, Bengt Glimelius, Philipp Grawe

  • 1Division of Medical Oncology, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland. vhess@uhbs.ch

The Lancet. Oncology
|February 6, 2008
PubMed
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Pretreatment serum carbohydrate antigen (CA) 19-9 levels predict survival in advanced pancreatic cancer. However, a decrease in CA 19-9 during chemotherapy does not significantly improve survival outcomes.

Area of Science:

  • Oncology
  • Clinical Chemistry

Background:

  • Carbohydrate antigen (CA) 19-9 is a tumor marker used in advanced pancreatic cancer.
  • Previous studies suggest a link between decreased CA 19-9 levels and improved survival during chemotherapy.

Purpose of the Study:

  • To evaluate if an early decrease in CA 19-9 concentration (by 50% at day 42) is associated with longer survival.
  • To determine if a 50% decrease from baseline to nadir CA 19-9 concentration has prognostic significance.
  • To assess CA 19-9 response as a potential surrogate endpoint for survival in clinical trials.

Main Methods:

  • CA 19-9 serum concentrations were measured at baseline and every 3 weeks in patients with advanced pancreatic cancer receiving gemcitabine-based chemotherapy.
  • Patients with baseline CA 19-9 below the upper limit of normal were excluded.

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  • Survival comparisons were adjusted for guarantee-time bias using the landmark method.

    • Main Results:

    • Higher baseline CA 19-9 concentrations were significantly associated with shorter overall survival (median 5.8 months vs. 10.3 months).
    • An early 50% decrease in CA 19-9 after two cycles was not linked to improved overall survival (median 10.1 months vs. 8.6 months).
    • A 50% decrease to nadir CA 19-9 concentration also did not correlate with significantly longer overall survival (median 7.8 months vs. 6.7 months).

    Conclusions:

    • Pretreatment serum CA 19-9 concentration is an independent prognostic factor for survival in advanced pancreatic cancer.
    • A decrease in CA 19-9 concentration during chemotherapy does not significantly correlate with improved survival.
    • CA 19-9 response during chemotherapy is not a valid surrogate endpoint for survival in clinical trials.