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CA19‐9 as a predictor of tumor response and survival in patients with advanced pancreatic cancer treated with gemcitabine based chemotherapy
Author(s) -
HAMMAD Nazik,
HEILBRUN Lance K,
PHILIP Philip A,
SHIELDS Anthony F,
ZALUPSKI Mark M,
VENKATRAMANAMOORTHY Raghu,
ELRAYES Bassel F
Publication year - 2010
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/j.1743-7563.2010.01290.x
Subject(s) - gemcitabine , medicine , pancreatic cancer , ca19 9 , hazard ratio , gastroenterology , chemotherapy , oncology , cancer , confidence interval
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 ≥ 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 ≥ 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 ≥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.