CEA, CA19-9, circulating DNA and circulating tumour cell kinetics in patients treated for metastatic colorectal cancer (mCRC).
Adult
Aged
Aged, 80 and over
Antigens, Tumor-Associated, Carbohydrate
/ metabolism
Carcinoembryonic Antigen
/ metabolism
Circulating Tumor DNA
/ genetics
Colorectal Neoplasms
/ drug therapy
Female
Gene Expression Regulation, Neoplastic
Humans
Male
Middle Aged
Neoplasm Metastasis
Neoplastic Cells, Circulating
/ drug effects
Prospective Studies
Survival Analysis
Up-Regulation
Journal
British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
31
07
2020
accepted:
28
04
2021
revised:
17
04
2021
pubmed:
12
6
2021
medline:
17
12
2021
entrez:
11
6
2021
Statut:
ppublish
Résumé
We previously reported that CEA kinetics are a marker of progressive disease (PD) in metastatic colorectal cancer (mCRC). This study was specifically designed to confirm CEA kinetics for predicting PD and to evaluate CA19-9, cell-free DNA (cfDNA), circulating tumour DNA (ctDNA) and circulating tumour cell (CTC) kinetics. Patients starting a chemotherapy (CT) with pre-treatment CEA > 5 ng/mL and/or CA19.9 > 30 UI/mL were prospectively included. Samples were collected from baseline to cycle 4 for CEA and CA19-9 and at baseline and the sixth week for other markers. CEA kinetics were calculated from the first to the third or fourth CT cycle. A total of 192 mCRC patients were included. CEA kinetics based on the previously identified >0.05 threshold was significantly associated with PD (p < 0.0001). By dichotomising by the median value, cfDNA, ctDNA and CA19-9 were associated with PD, PFS and OS in multivariate analysis. A circulating scoring system (CSS) combining CEA kinetics and baseline CA19-9 and cfDNA values classified patients based on high (n = 58) and low risk (n = 113) of PD and was independently associated with PD (ORa = 4.6, p < 0.0001), PFS (HRa = 2.07, p < 0.0001) and OS (HRa = 2.55, p < 0.0001). CEA kinetics alone or combined with baseline CA19-9 and cfDNA are clinically relevant for predicting outcomes in mCRC. NCT01212510.
Sections du résumé
BACKGROUND
We previously reported that CEA kinetics are a marker of progressive disease (PD) in metastatic colorectal cancer (mCRC). This study was specifically designed to confirm CEA kinetics for predicting PD and to evaluate CA19-9, cell-free DNA (cfDNA), circulating tumour DNA (ctDNA) and circulating tumour cell (CTC) kinetics.
METHODS
Patients starting a chemotherapy (CT) with pre-treatment CEA > 5 ng/mL and/or CA19.9 > 30 UI/mL were prospectively included. Samples were collected from baseline to cycle 4 for CEA and CA19-9 and at baseline and the sixth week for other markers. CEA kinetics were calculated from the first to the third or fourth CT cycle.
RESULTS
A total of 192 mCRC patients were included. CEA kinetics based on the previously identified >0.05 threshold was significantly associated with PD (p < 0.0001). By dichotomising by the median value, cfDNA, ctDNA and CA19-9 were associated with PD, PFS and OS in multivariate analysis. A circulating scoring system (CSS) combining CEA kinetics and baseline CA19-9 and cfDNA values classified patients based on high (n = 58) and low risk (n = 113) of PD and was independently associated with PD (ORa = 4.6, p < 0.0001), PFS (HRa = 2.07, p < 0.0001) and OS (HRa = 2.55, p < 0.0001).
CONCLUSIONS
CEA kinetics alone or combined with baseline CA19-9 and cfDNA are clinically relevant for predicting outcomes in mCRC.
TRIAL REGISTRATION NUMBER
NCT01212510.
Identifiants
pubmed: 34112948
doi: 10.1038/s41416-021-01431-9
pii: 10.1038/s41416-021-01431-9
pmc: PMC8405627
doi:
Substances chimiques
Antigens, Tumor-Associated, Carbohydrate
0
Carcinoembryonic Antigen
0
Circulating Tumor DNA
0
carbohydrate antigen 199, human
0
Banques de données
ClinicalTrials.gov
['NCT01212510']
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
725-733Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature Limited.
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