> Detailanzeige

Seelen, Leonard W.F.; Doppenberg, Deesje; Stoop, Thomas F.; Nagelhout, Anne; Brada, Lilly J.H.; Bosscha, Koop; Busch, Olivier R.; Cirkel, Geert A.; den Dulk, Marcel; Daams, Freek; van Dieren, Susan; van Eijck, Casper H.J.; Festen, Sebastiaan; Groot Koerkamp, Bas; Haj Mohammad, Nadia; de Hingh, Ignace H.J.T.; Lips, Daan J.; Los, Maartje; de Meijer, Vincent E.; Patijn, Gijs A.; Polée, Marco B.; Stommel, Martijn W.J.; Walma, Marieke S.; de Wilde, Roeland F.; [...]

Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients With Locally Advanced Pancreatic Cancer : A Nationwide Multicenter Study

Literatur-
verwaltung

Zur
Merkliste

Lösche von
Merkliste

Per Whatsapp teilen

Schließen

Merkliste



Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
  • Medientyp: E-Artikel
  • Titel: Minimum and Optimal CA19-9 Response After Two Months Induction Chemotherapy in Patients With Locally Advanced Pancreatic Cancer : A Nationwide Multicenter Study : A Nationwide Multicenter Study
  • Beteiligte: Seelen, Leonard W.F.; Doppenberg, Deesje; Stoop, Thomas F.; Nagelhout, Anne; Brada, Lilly J.H.; Bosscha, Koop; Busch, Olivier R.; Cirkel, Geert A.; den Dulk, Marcel; Daams, Freek; van Dieren, Susan; van Eijck, Casper H.J.; Festen, Sebastiaan; Groot Koerkamp, Bas; Haj Mohammad, Nadia; de Hingh, Ignace H.J.T.; Lips, Daan J.; Los, Maartje; de Meijer, Vincent E.; Patijn, Gijs A.; Polée, Marco B.; Stommel, Martijn W.J.; Walma, Marieke S.; de Wilde, Roeland F.; [...]
  • Erschienen: Ovid Technologies (Wolters Kluwer Health), 2024
  • Erschienen in: Annals of Surgery, 279 (2024) 5, Seite 832-841
  • Sprache: Englisch
  • DOI: 10.1097/sla.0000000000006021
  • ISSN: 0003-4932
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: 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.