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How to integrate serum tumor markers into clinical oncologic practice
1Groene Hart Ziekenhuis, Department of Nuclear Medicine, Gouda, The Netherlands.
Nutrition (Burbank, Los Angeles County, Calif.)
|September 1, 1995
Summary
Tumor markers show promise in managing epithelial cancers, aiding early detection and treatment monitoring. Specific markers like PSA for prostate cancer and CA-125 for ovarian cancer improve patient care by guiding treatment decisions.
Area of Science:
- Oncology
- Biomarker Research
- Clinical Diagnostics
Background:
- Epithelial cancers present diagnostic challenges due to insufficient sensitivity and specificity of many tumor markers.
- Effective patient management requires identifying reliable tumor markers for specific cancer types.
- Current clinical practice needs better tools for early detection, prognosis, and treatment monitoring.
Purpose of the Study:
- To evaluate the clinical utility of various serum and urine tumor markers in different epithelial cancers.
- To determine which tumor markers are most effective for screening, monitoring disease progression, and predicting treatment outcomes.
- To highlight the potential of specific tumor markers to guide patient management and improve care.
Main Methods:
- Review and synthesis of existing studies on serum and urine tumor markers in epithelial cancers.
- Analysis of marker performance in prostate, ovarian, breast, colorectal, gastrointestinal, bladder, and lung cancers.
- Comparison of marker utility against established clinical criteria (e.g., UICC) and imaging methods.
Main Results:
- Prostate-specific antigen (PSA) is valuable for prostate cancer screening and monitoring.
- Cancer antigen 125 (CA-125) aids in monitoring chemotherapy for ovarian cancer.
- For advanced breast cancer, changes in CA 15-3, CEA, and TPA predict outcomes.
- CEA and TPA detect colorectal cancer recurrence earlier than imaging.
- TPA is sensitive for chemotherapy response in gastrointestinal cancers.
- Urinary cytokeratins and neuron-specific enolase show promise in bladder and small-cell lung cancer, respectively.
- Cytokeratins may predict chemotherapy response in non-small-cell lung cancer.
Conclusions:
- Specific tumor markers offer valuable clinical applications in various epithelial cancers when used appropriately.
- These markers can enhance patient management by enabling earlier detection, monitoring treatment response, and predicting outcomes.
- The judicious use of tumor markers can potentially reduce the need for more invasive and costly diagnostic procedures, improving overall patient care.