ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer.
OBJECTIVE
To update the recommendations for the use of tumor marker tests in the prevention, screening, treatment, and surveillance of gastrointestinal cancers.


METHODS
For the 2006 update, an update committee composed of members from the full Panel was formed to complete the review and analysis of data published since 1999. Computerized literature searches of Medline and the Cochrane Collaboration Library were performed. The Update Committee's literature review focused attention on available systematic reviews and meta-analyses of published tumor marker studies.
For colorectal cancer, it is recommended that carcinoembryonic antigen (CEA) be ordered preoperatively, if it would assist in staging and surgical planning. Postoperative CEA levels should be performed every 3 months for stage II and III disease for at least 3 years if the patient is a potential candidate for surgery or chemotherapy of metastatic disease. CEA is the marker of choice for monitoring the response of metastatic disease to systemic therapy. Data are insufficient to recommend the routine use of p53, ras, thymidine synthase, dihydropyrimidine dehydrogenase, thymidine phosphorylase, microsatellite instability, 18q loss of heterozygosity, or deleted in colon cancer (DCC) protein in the management of patients with colorectal cancer. For pancreatic cancer, CA 19-9 can be measured every 1 to 3 months for patients with locally advanced or metastatic disease receiving active therapy. Elevations in serial CA 19-9 determinations suggest progressive disease but confirmation with other studies should be sought. New markers and new evidence to support the use of the currently reviewed markers will be evaluated in future updates of these guidelines.
Locker
Gershon Y
GY
American Society of Clinical Oncology Tumor Markers Expert Panel, Alexandria, VA 22314, USA.
Hamilton
Stanley
S
Harris
Jules
J
Jessup
John M
JM
Kemeny
Nancy
N
Macdonald
John S
JS
Somerfield
Mark R
MR
Hayes
Daniel F
DF
Bast
Robert C
RC
D014408:Biomarkers, Tumor / Q000032:analysis* / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000737:chemistry; D000075389:DCC Receptor; D004273:DNA, Neoplasm; D042943:Dihydrouracil Dehydrogenase (NADP) / Q000032:analysis; D005770:Gastrointestinal Neoplasms / Q000097:blood* / Q000737:chemistry* / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D011905:Genes, ras; D006801:Humans; D007150:Immunohistochemistry; D019656:Loss of Heterozygosity; D008403:Mass Screening / Q000379:methods; D053842:Microsatellite Instability; D009154:Mutation; D011003:Ploidies; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011322:Primary Prevention / Q000379:methods; D011956:Receptors, Cell Surface / Q000032:analysis; D013939:Thymidine Phosphorylase / Q000032:analysis; D013940:Thymidylate Synthase / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000097:blood; D025521:Tumor Suppressor Proteins / Q000032:analysis
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D000075389:DCC Receptor; C501909:DCC protein, human; D004273:DNA, Neoplasm; D011956:Receptors, Cell Surface; D016159:Tumor Suppressor Protein p53; D025521:Tumor Suppressor Proteins; D042943:Dihydrouracil Dehydrogenase (NADP); D013940:Thymidylate Synthase; D013939:Thymidine Phosphorylase