title: Assessing novel prognostic serum biomarkers in advanced pancreatic cancer: the role of CYFRA 21-1, serum amyloid A, haptoglobin, and 25-OH vitamin D3.
abstract: The present prospective single-center study investigated the prognostic role of novel serum biomarkers in advanced pancreatic cancer (PC). Patients (pts) with locally advanced or metastatic PC treated with first-line palliative chemotherapy were included. Among others, the serum markers CYFRA 21-1, haptoglobin, serum-amyloid A (SAA), and 25-OH vitamin D3 were determined at baseline and categorized by pre-defined cut-offs [median values (MV), upper limits of normal (ULN), lower limits of normal (LLN), or the natural logarithm (ln)] and correlated with overall survival (OS). Among the 59 pts included, pre-treatment CYFRA 21-1 levels showed a strong correlation with OS independent of the applied cut-off (MV 4.9 ng/ml-14.2 vs. 4.2 months, HR 0.18, p = 0.001; ULN 3.3 ng/ml-14.2 vs. 4.4 months, HR 0.28, p = 0.003; [ln] CYFRA 21-1-HR 0.77, p = 0.013). Lower values of haptoglobin were additionally associated with an improvement in OS (categorized by LLN of 2.05 g/l-10.4 vs. 5.5 months, HR 0.46, p = 0.023; [ln] haptoglobin-HR 0.51, p = 0.036). Pts with baseline SAA values below the MV of 22 mg/l also had a prolonged OS (10.4 vs. 5.0 months, HR 0.47, p = 0.036). For 25-OH vitamin D3 levels, no significant correlation with OS was found. In multivariate analyses, pre-treatment CYFRA 21-1 levels (categorized by MV-HR 0.15, p = 0.032) as well as [ln] haptoglobin (HR 0.30, p = 0.006) retained their independent prognostic significance for OS. CYFRA 21-1, haptoglobin, and SAA might provide useful prognostic information in advanced PC. An external multicenter validation of these results is necessary.
authors.affiliation: Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Marchioninistr. 15, 81377, Munich, Germany, michael.haas@med.uni-muenchen.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Haas
authors.forename: Christoph
authors.initials: C
authors.lastname: Kern
authors.forename: Stephan
authors.initials: S
authors.lastname: Kruger
authors.forename: Marlies
authors.initials: M
authors.lastname: Michl
authors.forename: Dominik P
authors.initials: DP
authors.lastname: Modest
authors.forename: Clemens
authors.initials: C
authors.lastname: Giessen
authors.forename: Christoph
authors.initials: C
authors.lastname: Schulz
authors.forename: Jobst C
authors.initials: JC
authors.lastname: von Einem
authors.forename: Steffen
authors.initials: S
authors.lastname: Ormanns
authors.forename: Rüdiger P
authors.initials: RP
authors.lastname: Laubender
authors.forename: Stefan
authors.initials: S
authors.lastname: Holdenrieder
authors.forename: Volker
authors.initials: V
authors.lastname: Heinemann
authors.forename: Stefan
authors.initials: S
authors.lastname: Boeck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000097:blood; D002762:Cholecalciferol / Q000097:blood*; D005260:Female; D006242:Haptoglobins; D006801:Humans; D053539:Keratin-19 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D000685:Serum Amyloid A Protein; D016019:Survival Analysis
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D006242:Haptoglobins; D053539:Keratin-19; D000685:Serum Amyloid A Protein; C102012:antigen CYFRA21.1; D002762:Cholecalciferol