The utility of monitoring carcinoembyronic antigen during systemic therapy for advanced colorectal cancer.
To determine if pre-treatment serum carcinoembryonic antigen (CEA) levels or changes in CEA values during treatment have prognostic value, we reviewed five prior fluorouracil/leucovorin-based trials and identified 125 colorectal cancer patients with no prior chemotherapy for metastatic disease in whom CEA values were available. Although pre-treatment serum CEA values did not predict for clinical response or time to progression, serial monitoring of CEA appeared to be useful in patients with an elevated pre-treatment CEA, particularly when a decrease in CEA occurred in concert with radiographic evidence of disease response. The CEA nadir was a strong prognostic variable with respect to time to disease progression. A consistent rise in CEA values over the minimum value signals the need for radiographic re-assessment of the patient's disease status to rule out disease progression.
Grem
J L
JL
NCI-Medicine Branch, NNMC, Building 8, Room 5101, 8901 Wisconsin Ave., Bethesda, MD, 20889-5105, USA.
Steinberg
S M
SM
Chen
A P
AP
McAtee
N
N
Cullen
E
E
Hamilton
J M
JM
Allegra
C J
CJ
D000328:Adult; D000368:Aged; D000931:Antidotes / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002986:Clinical Trials as Topic; D003110:Colonic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012004:Rectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis
D000931:Antidotes; D000964:Antimetabolites, Antineoplastic; D002272:Carcinoembryonic Antigen; D002955:Leucovorin; D005472:Fluorouracil