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CA 19-9 Response as an Early Indicator of the Effectiveness of Gemcitabine in Patients with Advanced Pancreatic Cancer

2008; Karger Publishers; Volume: 75; Issue: 1-2 Linguagem: Inglês

10.1159/000155213

1423-0232

Yousuke Nakai, Takao Kawabe, Hiroyuki Isayama, Takashi Sasaki, Hiroshi Yagioka, Yoko Yashima, Hirofumi Kogure, Toshihiko Arizumi, Osamu Togawa, Yukiko Ito, Saburo Matsubara, Kenji Hirano, Naoki Sasahira, Takeshi Tsujino, Minoru Tada, Masao Omata,

Gastric Cancer Management and Outcomes

The CA 19-9 decline 8 weeks after gemcitabine administration has been shown to be a useful prognosticator of survival in patients with pancreatic cancer. We assessed the prognostic value of changes in CA 19-9 levels 4 weeks after treatment initiation on overall survival (OS) and time to progression (TTP).We evaluated 72 patients who received gemcitabine for advanced pancreatic cancer. The serum CA 19-9 level was measured routinely at baseline (CA 19-9_Pre) and after the first (4 weeks; CA 19-9_A1) and second (8 weeks; CA 19-9_A2) courses. CA 19-9 responses were categorized into quartiles using the proportional change in CA 19-9.The rates of decrease in CA 19-9_A1 and CA 19-9_A2 were strongly correlated with each other (r = 0.8981, p < 0.0001). Multivariate analysis revealed that an early CA 19-9 response was prognostic of OS and TTP in addition to CA 19-9_Pre and performance status. Compared with the first quartile of an early CA 19-9 response, hazard ratios for the second, third and fourth quartiles were 0.91 (95% confidence interval, CI, 0.59-1.34), 0.71 (95% CI, 0.45-1.08), and 0.63 (95% CI, 0.41-0.94) for TTP, respectively (p for trend = 0.002), and 0.98 (95% CI, 0.61-1.49), 0.68 (95% CI, 0.40-1.08) and 0.79 (95% CI, 0.50-1.21) for OS (p for trend = 0.036).CA 19-9 response after the first course of gemcitabine was a prognosticator of OS and TTP in patients with advanced pancreatic cancer.