Tumor Biology

, Volume 36, Issue 8, pp 6471–6476 | Cite as

Tumor marker analyses in patients with brain metastases: patterns of practice and implications for survival prediction research

  • Carsten Nieder
  • Astrid Dalhaug
  • Ellinor Haukland
  • Bård Mannsåker
  • Adam Pawinski
Research Article


This study aims to explore patterns of practice of tumor marker analyses and potential prognostic impact of abnormal markers in patients with brain metastases from solid tumors. Previously, lactate dehydrogenase (LDH) and albumin were identified as relevant biomarkers. We performed a retrospective analysis of 120 patients with known LDH and albumin treated with whole-brain radiotherapy (WBRT) in two different situations: (1) brain metastases detected at initial cancer diagnosis (n = 46) and (2) brain metastases at later time points (n = 74, median interval 13 months). Twenty-six patients (57 %) from group 1 had at least one tumor marker analyzed, and 11 patients (24 %) had abnormal results. Twenty-two patients (30 %) from group 2 had at least one tumor marker analyzed, and 16 patients (22 %) had abnormal results. When assuming that LDH and albumin would be standard tests before WBRT, additional potential biomarkers were found in 36 % of patients with normal LDH and albumin. Marker positivity rates were for example 80 % for carcinoembryonic antigen (CEA) in colorectal cancer and 79 % for CA 15-3 in breast cancer. Abnormal markers were associated with presence of liver metastases. CA 15-3 values above median predicted shorter survival in patients with breast cancer (median 1.9 vs. 13.8 months, p = 0.1). Comparable trends were not observed for various markers in other tumor types. In conclusion, only a minority of patients had undergone tumor marker analyses. Final group sizes were too small to perform multivariate analyses or draw definitive conclusions. We hypothesize that CA 15-3 could be a promising biomarker that should be studied further.


Brain metastases Lactate dehydrogenase Albumin Prognostic factors Radiotherapy Tumor marker CA 15-3 



Cancer antigen


Carcinoembryonic antigen


Computed tomography


Diagnosis-specific graded prognostic assessment score




Serum lactate dehydrogenase


Magnetic resonance imaging


Non-small cell lung cancer


Serum neuron-specific enolase


Prostate-specific antigen


Whole-brain radiotherapy


Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  • Carsten Nieder
    • 1
    • 2
  • Astrid Dalhaug
    • 1
    • 2
  • Ellinor Haukland
    • 1
  • Bård Mannsåker
    • 1
  • Adam Pawinski
    • 1
  1. 1.Department of Oncology and Palliative MedicineNordland HospitalBodøNorway
  2. 2.Institute of Clinical Medicine, Faculty of Health SciencesUniversity of TromsøTromsøNorway

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