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. 2000 Feb 1;82(5):1013–1016. doi: 10.1054/bjoc.1999.1035

Decrease of CA 19–9 during chemotherapy with gemcitabine predicts survival time in patients with advanced pancreatic cancer

U Halm 1, T Schumann 1, I Schiefke 1, H Witzigmann 2, J Mössner 1, V Keim 1
PMCID: PMC2374423  PMID: 10737382

Abstract

Chemotherapy with gemcitabine has been shown to be an effective regimen in advanced or metastatic pancreatic cancer with improvement of both quality of life and survival time. The response of the tumour marker CA 19–9 to chemotherapy with gemcitabine was studied in order to find out whether it is related to survival time of patients. Forty-three consecutive patients (median age 61 years, range 39–76 years; 20 males, 23 females) suffering from histologically proven locally advanced or metastatic pancreatic adenocarcinoma and a baseline Karnofsky-index ≥ 60 were treated with gemcitabine in a dose of 1000 mg m−2weekly × 7 followed by 1 week of rest during the first cycle and thereafter 1000 mg m−2weekly × 3 followed by 1 week of rest until progression. In 36 of 43 patients serial measurements of CA 19–9 could be performed. Patients with a decrease of > 20% of the baseline CA 19–9 level after 8 weeks of treatment (n = 25) had a significantly better median survival than patients with a rise or a decrease ≤ 20% (n = 11) (268 vs 110 days;P< 0.001). The response of CA 19–9 was the strongest independent predictor of survival (P< 0.001) in the multivariate analysis. In conclusion, a decrease of CA 19–9 > 20% during the first weeks of chemotherapy with gemcitabine is associated with a better survival of patients with locally advanced or metastatic pancreatic cancer. Serial measurements of CA 19–9 are useful to decide whether further chemotherapy after the first weeks of treatment is indicated. © 2000 Cancer Research Campaign

Keywords: pancreatic cancer, chemotherapy, CA 19–9, gemcitabine

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Selected References

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  1. Aapro M. S., Martin C., Hatty S. Gemcitabine--a safety review. Anticancer Drugs. 1998 Mar;9(3):191–201. doi: 10.1097/00001813-199803000-00001. [DOI] [PubMed] [Google Scholar]
  2. Ahlgren J. D. Chemotherapy for pancreatic carcinoma. Cancer. 1996 Aug 1;78(3 Suppl):654–663. doi: 10.1002/(SICI)1097-0142(19960801)78:3<654::AID-CNCR46>3.0.CO;2-V. [DOI] [PubMed] [Google Scholar]
  3. Burris H. A., 3rd, Moore M. J., Andersen J., Green M. R., Rothenberg M. L., Modiano M. R., Cripps M. C., Portenoy R. K., Storniolo A. M., Tarassoff P. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997 Jun;15(6):2403–2413. doi: 10.1200/JCO.1997.15.6.2403. [DOI] [PubMed] [Google Scholar]
  4. Carmichael J., Fink U., Russell R. C., Spittle M. F., Harris A. L., Spiessi G., Blatter J. Phase II study of gemcitabine in patients with advanced pancreatic cancer. Br J Cancer. 1996 Jan;73(1):101–105. doi: 10.1038/bjc.1996.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Glenn J., Steinberg W. M., Kurtzman S. H., Steinberg S. M., Sindelar W. F. Evaluation of the utility of a radioimmunoassay for serum CA 19-9 levels in patients before and after treatment of carcinoma of the pancreas. J Clin Oncol. 1988 Mar;6(3):462–468. doi: 10.1200/JCO.1988.6.3.462. [DOI] [PubMed] [Google Scholar]
  6. Gogas H., Lofts F. J., Evans T. R., Daryanani S., Mansi J. L. Are serial measurements of CA19-9 useful in predicting response to chemotherapy in patients with inoperable adenocarcinoma of the pancreas? Br J Cancer. 1998;77(2):325–328. doi: 10.1038/bjc.1998.50. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Ishii H., Okada S., Nose H., Yoshimori M., Aoki K., Okusaka T. Prognostic factors in patients with advanced pancreatic cancer treated with systemic chemotherapy. Pancreas. 1996 Apr;12(3):267–271. doi: 10.1097/00006676-199604000-00009. [DOI] [PubMed] [Google Scholar]
  8. Katz A., Hanlon A., Lanciano R., Hoffman J., Coia L. Prognostic value of CA 19-9 levels in patients with carcinoma of the pancreas treated with radiotherapy. Int J Radiat Oncol Biol Phys. 1998 May 1;41(2):393–396. doi: 10.1016/s0360-3016(98)00058-3. [DOI] [PubMed] [Google Scholar]
  9. Koprowski H., Steplewski Z., Mitchell K., Herlyn M., Herlyn D., Fuhrer P. Colorectal carcinoma antigens detected by hybridoma antibodies. Somatic Cell Genet. 1979 Nov;5(6):957–971. doi: 10.1007/BF01542654. [DOI] [PubMed] [Google Scholar]
  10. Lundin J., Roberts P. J., Kuusela P., Haglund C. The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer. Br J Cancer. 1994 Mar;69(3):515–519. doi: 10.1038/bjc.1994.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Okusaka T., Okada S., Sato T., Wakasugi H., Saisho H., Furuse J., Ishikawa O., Matsuno S., Yokoyama S. Tumor markers in evaluating the response to radiotherapy in unresectable pancreatic cancer. Hepatogastroenterology. 1998 May-Jun;45(21):867–872. [PubMed] [Google Scholar]
  12. Pleskow D. K., Berger H. J., Gyves J., Allen E., McLean A., Podolsky D. K. Evaluation of a serologic marker, CA19-9, in the diagnosis of pancreatic cancer. Ann Intern Med. 1989 May 1;110(9):704–709. doi: 10.7326/0003-4819-110-9-704. [DOI] [PubMed] [Google Scholar]
  13. Rothenberg M. L., Abbruzzese J. L., Moore M., Portenoy R. K., Robertson J. M., Wanebo H. J. A rationale for expanding the endpoints for clinical trials in advanced pancreatic carcinoma. Cancer. 1996 Aug 1;78(3 Suppl):627–632. doi: 10.1002/(SICI)1097-0142(19960801)78:3<627::AID-CNCR43>3.0.CO;2-Y. [DOI] [PubMed] [Google Scholar]
  14. Rothenberg M. L., Moore M. J., Cripps M. C., Andersen J. S., Portenoy R. K., Burris H. A., 3rd, Green M. R., Tarassoff P. G., Brown T. D., Casper E. S. A phase II trial of gemcitabine in patients with 5-FU-refractory pancreas cancer. Ann Oncol. 1996 Apr;7(4):347–353. doi: 10.1093/oxfordjournals.annonc.a010600. [DOI] [PubMed] [Google Scholar]
  15. Safi F., Schlosser W., Falkenreck S., Beger H. G. Prognostic value of CA 19-9 serum course in pancreatic cancer. Hepatogastroenterology. 1998 Jan-Feb;45(19):253–259. [PubMed] [Google Scholar]
  16. Schnall S. F., Macdonald J. S. Chemotherapy of adenocarcinoma of the pancreas. Semin Oncol. 1996 Apr;23(2):220–228. [PubMed] [Google Scholar]
  17. Tian F., Appert H. E., Myles J., Howard J. M. Prognostic value of serum CA 19-9 levels in pancreatic adenocarcinoma. Ann Surg. 1992 Apr;215(4):350–355. doi: 10.1097/00000658-199204000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]

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