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Cancer Chemotherapy and Pharmacology

, Volume 73, Issue 2, pp 409–416 | Cite as

CA19-9 level as a prognostic and predictive factor of bevacizumab efficacy in metastatic colorectal cancer patients undergoing oxaliplatin-based chemotherapy

  • Yukiya Narita
  • Hiroya Taniguchi
  • Azusa Komori
  • Sohei Nitta
  • Kazuhisa Yamaguchi
  • Chihiro Kondo
  • Motoo Nomura
  • Shigenori Kadowaki
  • Daisuke Takahari
  • Takashi Ura
  • Masashi Andoh
  • Kei Muro
Original Article

Abstract

Purpose

The prognostic and predictive values of carbohydrate antigen 19-9 (CA19-9) levels in metastatic colorectal cancer (mCRC) remain unclear. We reviewed all mCRC patients at a single institution to evaluate the relationship between CA19-9 levels and survival.

Methods

Two hundred and fifty-two patients underwent first-line chemotherapy using oxaliplatin-based regimens between April 2005 and December 2009. The relationship between baseline CA19-9 levels and survival was analyzed. Moreover, we evaluated the relationship between baseline CA19-9 levels and clinicopathological factors.

Results

One hundred and fifty patients had elevated baseline CA19-9 levels (elevated group), and 79 patients had normal baseline CA19-9 (normal group) levels. Both KRAS and BRAF mutation rates were higher in the elevated group than in the normal group. Elevated CA19-9 level was a poor prognostic factor compared with normal CA19-9 levels (P = 0.0021). In the elevated group, the median survival time with bevacizumab was significantly longer with bevacizumab than without it (median OS, 27.8 vs. 15.3 months, P = 0.0019). However, the median survival time was not different with or without bevacizumab in the normal group (median OS, 36.5 vs. 38.0 months, P = 0.9515).

Conclusion

Our results suggest that baseline CA19-9 level is an independent prognostic factor in mCRC patients, and it correlated with the KRAS/BRAF mutation status. Bevacizumab exhibits clinical activity only for high CA19-9 levels in mCRC.

Keywords

Bevacizumab Carbohydrate antigen 19-9 Colorectal cancer Predictive factor Prognostic factor 

Notes

Conflict of interest

The authors have declared no conflicts of interest.

Supplementary material

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Yukiya Narita
    • 1
  • Hiroya Taniguchi
    • 1
  • Azusa Komori
    • 1
  • Sohei Nitta
    • 1
  • Kazuhisa Yamaguchi
    • 1
  • Chihiro Kondo
    • 1
  • Motoo Nomura
    • 1
  • Shigenori Kadowaki
    • 1
  • Daisuke Takahari
    • 1
  • Takashi Ura
    • 1
  • Masashi Andoh
    • 1
  • Kei Muro
    • 1
  1. 1.Department of Clinical OncologyAichi Cancer Center HospitalNagoyaJapan

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