PROGNOSTIC-SIGNIFICANCE OF PREIMMUNOTHERAPY SERUM CA27.29 (MUC-1) MUCIN LEVEL AFTER ACTIVE SPECIFIC IMMUNOTHERAPY OF METASTATIC ADENOCARCINOMA PATIENTS

The TRUQUANT BR radioimmunoassay, which uses monoclonal antibody B27.2 9 to quantitate CA27.29 mucin antigen (MUC-1 gene product) in serum, h as recently received Food and Drug Administration approval for predict ing recurrent breast cancer in patients with stage II and III disease, The purpose of this study was to determine whether the new radioimmun oassay for serum MUC-1 has prognostic significance for patients with m etastatic adenocarcinoma receiving active specific immunotherapy (ASI) . Using 40 U/ml as the upper limit of ''normal,'' patients with metast atic breast and ovarian cancer with a preimmunotherapy serum CA27.29 m ucin >40 U/ml (CA27.29 Hi patients) had a poorer survival than CA27.29 Lo patients (less than or equal to 40 U/ml) after ASI. There was no s ignificant correlation between preimmunotherapy CA27.29 serum levels a nd measurable tumor burden, The preimmunotherapy CA27.29 serum level w as a predictor of poor survival of metastatic colorectal and pancreati c cancer patients independent of other prognostic factors, There seeme d to be two populations of pancreatic cancer patients, separated at 60 U/ml serum CA27.29 (CA27.29 Hi versus Lo patients), A CA27.29 serum l evel of 22 U/ml separated patients with CA27.29 Hi vs, Lo colorectal c ancer. Patients with CA27.29 Lo colorectal and pancreatic cancer survi ved longer after ASI compared with patients with CA27.29 Hi colorectal and pancreatic cancer, respectively. We suggest that various CA27.29 serum levels define poor prognosis patients (CA27.29 Wi secretors) ver sus good prognosis patients (CA27.29 Lo secretors) for different cance r types.