CA19-9: A pedictor of response in pancreatic cancer treated with gemcitabine and cisplatin

The question was asked whether kinetics of CA19-9 would serve as a predicto r of chemotherapeutic oucome in advanced pancreatic cancer treated with gem citabine and cisplatin. Twenty one patients, 5 females and 16; males (media n age 56 yrs, range 36 - 71 yrs) suffering from adenocarcinoma of the exocr ine pancreas were analysed. Chemotherapy was applied for a median of 6 cour ses (range 2-21). Four patients achieved a complete remission, four a parti al remission (OR = 38%), while stable disease was documented in 8 and progr essive disease in 5 patients. Among 4 CR patients, all demonstrated a signi ficant decline of CA 19-9 levels during the initial three treatment courses with apparent half-lifes of 15, 18, 24, and 33 days. At a cut-off level of 37 U/mL, all CR patients reached normal values in the course of treatment. All patients achieving PR showed a decrease of CA 19-9 values at apparent half-lifes of 9, 16, 88 and 89 days. Among patients with stable disease, CA 19-9 transiently decreased in 7/8 patients and remained stable in I patient . However, values increased later in all patients after a median of 3 treat ment courses (range 2-9). In patients with disease progression, CA 19-9 ini tially increased in 4/5 patients, while a further patient did so only beyou nd 100 days of treatment. In conclusion, kinetics of CA19-9 serum concentra tion may serve as an early indicator of response to gemcitabine/cisplatin c hemotherapy in advanced pancreatic cancer.