Prognostic role of carcinoembryonic antigen and carbohydrate antigen 19-9 in metastatic colorectal cancer [Elektronisk resurs] a BRAF-mutant subset with high CA 19-9 level and poor outcome
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Thomsen, Maria (författare)
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Skovlund, Eva (författare)
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Sorbye, Halfdan (författare)
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Bolstad, Nils (författare)
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Nustad, Kjell Johannes (författare)
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Glimelius, Bengt (författare)
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Pfeiffer, Per (författare)
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Kure, Elin H. (författare)
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Johansen, Julia S. (författare)
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Tveit, Kjell Magne (författare)
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Christoffersen, Thoralf (författare)
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Guren, Tormod Kyrre (författare)
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Uppsala universitet Medicinska och farmaceutiska vetenskapsområdet (utgivare)
- Publicerad: NATURE PUBLISHING GROUP, 2018
- Engelska.
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Ingår i: British Journal of Cancer. - 0007-0920. ; 118:12, 1609-1616
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- BACKGROUND: Mutation status of RAS and BRAF, as well as serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9), are biomarkers used in clinical management of patients with gastrointestinal cancers. This study aimed to examine the prognostic role of these biomarkers in a patient population that started first-line chemotherapy for unresectable metastatic colorectal cancer (mCRC) in the NORDIC-VII study. METHODS: CEA and CA 19-9 were measured in serum samples from 545 patients obtained before the start of chemotherapy. Four hundred and ninety-four patients had detectable levels of carbohydrate antigen 19-9 (CA 19-9). RAS (exons 2-4) and BRAF (V600E) mutation status were available from 440 patients. Overall survival (OS) was estimated in patient groups defined by serum CEA or CA 19-9 levels using cut-off values of 5 mu g/L and 35 kU/L, respectively, in the total population and in subgroups according to RAS and BRAF mutation status. RESULTS: For both CEA and CA 19-9, elevated serum levels were associated with reduced OS in adjusted analyses which included RAS and BRAF mutation status, baseline World Health Organization performance status, and levels of alkaline phosphatase and C-reactive protein. The negative prognostic information provided by an elevated CA 19-9 level was particularly marked in patients with BRAF mutation (hazard ratio = 4.35, interaction P = 0.003, in an adjusted model for OS). CONCLUSIONS: High baseline serum concentrations of CEA and CA 19-9 provide independent information of impaired prognosis in mCRC. In patients with BRAF-mutant tumours, elevated serum CA 19-9 may identify a subgroup with highly aggressive disease and could contribute to improving therapeutic decisions.
Ämnesord
- Medical and Health Sciences (hsv)
- Clinical Medicine (hsv)
- Cancer and Oncology (hsv)
- Medicin och hälsovetenskap (hsv)
- Klinisk medicin (hsv)
- Cancer och onkologi (hsv)
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