Serum tumor markers for patient monitoring: a case-oriented approach illustrated with carcinoembryonic antigen.
The effectiveness of patient monitoring with serum tumor markers is improved when the patient's pretreatment baseline is established, regular serial testing is performed, and a clinically significant change of the marker is determined on the basis of objective criteria. Attention must be directed to (a) ensuring long-term assay precision, (b) timing specimen collection to avoid misinterpretation of paradoxical increases (induced by chemotherapy, surgery, or radiation), (c) noting changes in the production or clearance mechanisms of the marker, and (d) recognizing the variability of site-response in patients who have multiple locations of metastatic disease. Clinical decisions to alter therapy should not be based only on tumor marker measurements. In the absence of other clinical data, a tumor marker abnormality should be confirmed with serial samples collected at a time interval dictated by the half-life of the marker. Serial tumor marker testing can improve cancer patient care, especially when effective salvage therapies are available.
Fritsche
H A
HA
Division of Laboratory Medicine, M.D. Anderson Cancer Center, University of Texas, Houston 77030.
D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen