Am. Cook et al., The utility of tumour markers in assessing the response to chemotherapy inadvanced bladder cancer, BR J CANC, 82(12), 2000, pp. 1952-1957
In patients with advanced bladder cancer receiving chemotherapy, early asse
ssment of response can avoid unnecessary toxicity. The aim of this study wa
s to assess the role of tumour markers in monitoring response. Serum levels
of one or more of markers beta human chorionic gonadotrophin (beta hCG), c
arcinoembryomic antigen (CEA), CA125 and CA19.9 were measured in 74 patient
s with advanced bladder cancer receiving chemotherapy from 1992 to 1997. Fo
rty-three of 74 (58%) of patients had at least one raised marker (1.5 times
upper limit of normal range). This was more common in patients with extra-
pelvic disease than in those with disease confined to the pelvis (P = 0.002
). Thirty-eight of 78 (49%) assessable patients had a radiological response
. Neither clinical response (P = 0.81) nor survival (P = 0.16) differed bet
ween marker-negative and marker-positive patients. Clinical response was st
rongly related to marker response in the 35 comparable patients (P = 0.0001
). No patient had a clinical response without response of at least one mark
er. Ninety per cent of patients who achieved a marker response had done so
by 8 weeks. Monitoring of tumour markers in patients with advanced bladder
cancer can help predict the response to chemotherapy. (C) 2000 Cancer Resea
rch Campaign.