دورية أكاديمية
Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients With Locally Advanced Pancreatic Cancer: A Nationwide Multicenter Study.
| العنوان: | Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients With Locally Advanced Pancreatic Cancer: A Nationwide Multicenter Study. |
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| المؤلفون: | Seelen LWF; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Doppenberg D; Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Stoop TF; Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands.; Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Nagelhout A; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Brada LJH; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Bosscha K; Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands., Busch OR; Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Cirkel GA; Department of Medical Oncology, Regional Academic Cancer Center Utrecht, Meander Medical Center Amersfoort, University Medical Center, Utrecht, The Netherlands., den Dulk M; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.; Department of General, Visceral and Transplant Surgery, University Hospital Aachen, Germany., Daams F; Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., van Dieren S; Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., van Eijck CHJ; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Festen S; Department of Surgery, OLVG, Amsterdam, The Netherlands., Groot Koerkamp B; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Haj Mohammad N; Department of Medical Oncology, Regional Academic Cancer Center Utrecht, University Medical Center, Utrecht, The Netherlands., de Hingh IHJT; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., Lips DJ; Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands., Los M; Department of Medical Oncology, Regional Academic Cancer Center Utrecht, St. Antonius Hospital Nieuwegein, University Medical Center, Utrecht, The Netherlands., de Meijer VE; Department of Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands., Patijn GA; Department of Surgery, Isala Clinics, Zwolle, The Netherlands., Polée MB; Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, The Netherlands., Stommel MWJ; Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands., Walma MS; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., de Wilde RF; Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Wilmink JW; Cancer Center Amsterdam, Amsterdam, The Netherlands.; Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Amsterdam, The Netherlands., Molenaar IQ; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., van Santvoort HC; Department of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, The Netherlands., Besselink MG; Amsterdam UMC, University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands. |
| مؤلفون مشاركون: | Dutch Pancreatic Cancer Group |
| المصدر: | Annals of surgery [Ann Surg] 2024 May 01; Vol. 279 (5), pp. 832-841. Date of Electronic Publication: 2023 Jul 21. |
| نوع المنشور: | Multicenter Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins |
| مواضيع طبية MeSH: | Antineoplastic Combined Chemotherapy Protocols*/therapeutic use , Pancreatic Neoplasms*/drug therapy, Humans ; CA-19-9 Antigen ; Fluorouracil/therapeutic use ; Gemcitabine ; Induction Chemotherapy |
| مستخلص: | Objective: This nationwide multicenter study aimed to define clinically relevant thresholds of relative serum CA19-9 response after 2 months of induction chemotherapy in patients with locally advanced pancreatic cancer (LAPC). Background: CA19-9 is seen as leading biomarker for response evaluation in patients with LAPC, but early clinically useful cut-offs are lacking. Methods: All consecutive patients with LAPC after 4 cycles (m)FOLFIRINOX or 2 cycles gemcitabine-nab-paclitaxel induction chemotherapy (±radiotherapy) with CA19-9 ≥5 U/mL at baseline were analyzed (2015-2019). The association of CA19-9 response with median OS (mOS) was evaluated for different CA19-9 cut-off points. Minimum and optimal CA19-9 response were established via log-rank test. Predictors for OS were analyzed using COX regression analysis. Results: Overall, 212 patients were included, of whom 42 (19.8%) underwent resection. Minimum CA19-9 response demonstrating a clinically significant median OS difference (12.7 vs. 19.6 months) was seen at ≥40% CA19-9 decrease. The optimal cutoff for CA19-9 response was ≥60% decrease (21.7 vs. 14.0 mo, P =0.021). Only for patients with elevated CA19-9 levels at baseline (n=184), CA19-9 decrease ≥60% [hazard ratio (HR)=0.59, 95% CI, 0.36-0.98, P =0.042] was independently associated with prolonged OS, as were SBRT (HR=0.42, 95% CI, 0.25-0.70; P =0.001), and resection (HR=0.25, 95% CI, 0.14-0.46, P <0.001), and duration of chemotherapy (HR=0.75, 95% CI, 0.69-0.82, P <0.001). Conclusions: CA19-9 decrease of ≥60% following induction chemotherapy as optimal response cut-off in patients with LAPC is an independent predictor for OS when CA19-9 is increased at baseline. Furthermore, ≥40% is the minimum cut-off demonstrating survival benefit. These cut-offs may be used when discussing treatment strategies during early response evaluation. Competing Interests: The authors report no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.) |
| التعليقات: | Comment in: Gland Surg. 2024 Mar 27;13(3):458-460. (PMID: 38601280) |
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| المشرفين على المادة: | 0 (CA-19-9 Antigen) U3P01618RT (Fluorouracil) 0 (Gemcitabine) |
| تواريخ الأحداث: | Date Created: 20230721 Date Completed: 20240408 Latest Revision: 20240424 |
| رمز التحديث: | 20240424 |
| DOI: | 10.1097/SLA.0000000000006021 |
| PMID: | 37477009 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1528-1140 |
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| DOI: | 10.1097/SLA.0000000000006021 |