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CA19-9 kinetics during systemic chemotherapy in patients with advanced or recurrent biliary tract cancer

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Abstract

Purpose

The role of carbohydrate antigen 19-9 (CA19-9) kinetics in patients with biliary tract cancer (BTC) receiving chemotherapy remains to be elucidated.

Methods

A total of 185 advanced or recurrent BTC patients receiving a first line chemotherapy between January 2006 and March 2016, were retrospectively studied. Serum CA19-9 was measured at baseline and after two cycles of chemotherapy, and patients were categorized based on CA19-9 response: CA19-9 decrease group (≥ 30% decrease), stable group (< 30% decrease and < 20% increase) and increase group (≥ 20% increase). The associations of CA19-9 response with radiological tumor response, progression-free survival (PFS) and overall survival (OS) were investigated.

Results

There was a statistically significant association between CA19-9 response and radiological tumor responses (p < 0.001). The median PFS and OS were significantly different among three groups according to CA19-9 response: PFS of 8.0, 5.7 and 3.5 months in CA19-9 decrease, stable and increase groups (p < 0.001) and OS of 18.8, 16.0 and 7.5 months in CA19-9 decrease, stable and increase groups, respectively (p < 0.001). Multivariate analyses showed that CA19-9 response was prognostic both of OS and PFS in addition, to CA19-9 at baseline, and performance status.

Conclusion

CA19-9 kinetics after the first two cycles of a first line chemotherapy was a prognostic factor for OS and PFS in patients with advanced and recurrent BTC.

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Abbreviations

BTC:

Biliary tract cancer

CA19-9:

Carbohydrate antigen 19-9

OS:

Overall survival

PFS:

Progression-free survival

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Acknowledgements

N.T., Y.N., and H.I.: conception and design of the study; collection, analysis, and interpretation of data; drafting of the article. T.S.: conception and design of the study; collection, analysis, and interpretation of data; critical revision of the article for important intellectual content. K.S., K.N., T.S., T.N., T.S., K.I., R.H., T.T., and R.U.: conception and design of the study; collection, analysis, and interpretation of data. S.M., H.K., M. T.: critical revision of the article for important intellectual content. K.K.: critical revision of the article for important intellectual content, and supervision of the study. All authors: final approval of the article.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Naminatsu Takahara, Yousuke Nakai, Kei Saito, Kensaku Noguchi, Tatsunori Suzuki, Tomoka Nakamura, Tatsuya Sato, Kazunaga Ishigaki, Ryunosuke Hakuta, Tsuyoshi Takeda, Rie Uchino, Suguru Mizuno, Hirofumi Kogure, Minoru Tada & Kazuhiko Koike

  2. Department of Gastroenterology, Graduate School of Medicine, Juntendo University, Tokyo, Japan

    Hiroyuki Isayama

  3. Division of Hepatobiliary and Pancreatic Medicine, Department of Gastroenterology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Takashi Sasaki

Authors
  1. Naminatsu Takahara
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  2. Yousuke Nakai
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  3. Hiroyuki Isayama
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  7. Tatsunori Suzuki
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  10. Kazunaga Ishigaki
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  11. Ryunosuke Hakuta
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  13. Rie Uchino
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  14. Suguru Mizuno
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  15. Hirofumi Kogure
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  16. Minoru Tada
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  17. Kazuhiko Koike
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Corresponding author

Correspondence to Yousuke Nakai.

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Funding

This study was not funded by any foundation, company, industry, or external source.

Conflict of interest

All authors declare no conflict of interest related to this article.

Ethical approval

This study was in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Takahara, N., Nakai, Y., Isayama, H. et al. CA19-9 kinetics during systemic chemotherapy in patients with advanced or recurrent biliary tract cancer. Cancer Chemother Pharmacol 80, 1105–1112 (2017). https://doi.org/10.1007/s00280-017-3456-9

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  • DOI: https://doi.org/10.1007/s00280-017-3456-9

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