Limited value of CA 19-9 in predicting early treatment failure in patients with advanced pancreatic cancer.
OBJECTIVE
The role of CA 19-9 in monitoring treatment response in advanced pancreatic cancer remains uncertain. We assessed its value in predicting early failure of first-line chemotherapy.


METHODS
Data of 84 patients with advanced pancreatic cancer who had received first-line chemotherapy were analyzed with regard to changes in CA 19-9 during the first 2 months of treatment.


RESULTS
Median time to progression and overall survival in patients with a transient increase in CA 19-9 during month 1 (n = 15; 5.5 and 13 months) and in those with no increase during the 2 months (n = 52; 6.5 and 12 months) were comparable and slightly above the median values of the entire study population. The hazard ratios for disease progression for a 20% increase in CA 19-9 during the first and second month of therapy were 1.065 and 1.339 in the univariate- and 1.092 and 1.298 in the multiple Cox regression model, respectively. CA 19-9 did not influence survival.


CONCLUSIONS
Our results suggest that early CA 19-9 measurements are weakly associated with disease progression rather than survival in patients with advanced pancreatic cancer receiving palliative chemotherapy. In view of a possible tumor marker flare, values after the first month of therapy must be interpreted with caution.
Vormittag
Laurenz
L
Division of Clinical Oncology, Department of Medicine I and Cancer Center, Medical University Vienna, Vienna, Austria.
Gleiss
Andreas
A
Scheithauer
Werner
W
Lang
Fritz
F
Laengle
Friedrich
F
Kornek
Gabriela V
GV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D017211:Treatment Failure
D018395:CA-19-9 Antigen