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Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial
AIM: To evaluate the prognostic value of tumor markers in a European cohort of patients with resectable gastric cancer. METHODS: We performed a post hoc analysis of the CRITICS trial, in which 788 patients received perioperative therapy. Association between survival and pretreatment CEA, CA 19-9, al...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Singapore
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882113/ https://www.ncbi.nlm.nih.gov/pubmed/34714423 http://dx.doi.org/10.1007/s10120-021-01258-6 |
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author | Slagter, Astrid E. Vollebergh, Marieke A. Caspers, Irene A. van Sandick, Johanna W. Sikorska, Karolina Lind, Pehr Nordsmark, Marianne Putter, Hein Braak, Jeffrey P. B. M. Meershoek-Klein Kranenbarg, Elma van de Velde, Cornelis J. H. Jansen, Edwin P. M. Cats, Annemieke van Laarhoven, Hanneke W. M. van Grieken, Nicole C. T. Verheij, Marcel |
author_facet | Slagter, Astrid E. Vollebergh, Marieke A. Caspers, Irene A. van Sandick, Johanna W. Sikorska, Karolina Lind, Pehr Nordsmark, Marianne Putter, Hein Braak, Jeffrey P. B. M. Meershoek-Klein Kranenbarg, Elma van de Velde, Cornelis J. H. Jansen, Edwin P. M. Cats, Annemieke van Laarhoven, Hanneke W. M. van Grieken, Nicole C. T. Verheij, Marcel |
author_sort | Slagter, Astrid E. |
collection | PubMed |
description | AIM: To evaluate the prognostic value of tumor markers in a European cohort of patients with resectable gastric cancer. METHODS: We performed a post hoc analysis of the CRITICS trial, in which 788 patients received perioperative therapy. Association between survival and pretreatment CEA, CA 19-9, alkaline phosphatase, neutrophils, hemoglobin and lactate dehydrogenase were explored in uni- and multivariable Cox regression analyses. Likelihoods to receive potentially curative surgery were investigated for patients without elevated tumor markers versus one of the tumor markers elevated versus both tumor markers elevated. The association between tumor markers and the presence of circulating tumor DNA (ctDNA) was explored in 50 patients with available ctDNA data. RESULTS: In multivariable analysis, in which we corrected for allocated treatment and other baseline characteristics, elevated pretreatment CEA (HR 1.43; 95% CI 1.11–1.85, p < 0.001) and CA 19-9 (HR 1.79; 95% CI 1.42–2.25, p < 0.001) were associated with worse OS. Likelihoods to receive potentially curative surgery were 86%, 77% and 60% for patients without elevated tumor marker versus either elevated CEA or CA 19-9 versus both elevated, respectively (p < 0.001). Although both preoperative presence of ctDNA and tumor markers were prognostic for survival, no association was found between these two parameters. CONCLUSION: CEA and CA 19-9 were independent prognostic factors for survival in a large cohort of European patients with resectable gastric cancer. No relationship was found between tumor markers and ctDNA. These factors could potentially guide treatment choices and should be included in future trials to determine their definitive position. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT00407186. EudraCT number: 2006-00413032. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10120-021-01258-6. |
format | Online Article Text |
id | pubmed-8882113 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-88821132022-03-02 Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial Slagter, Astrid E. Vollebergh, Marieke A. Caspers, Irene A. van Sandick, Johanna W. Sikorska, Karolina Lind, Pehr Nordsmark, Marianne Putter, Hein Braak, Jeffrey P. B. M. Meershoek-Klein Kranenbarg, Elma van de Velde, Cornelis J. H. Jansen, Edwin P. M. Cats, Annemieke van Laarhoven, Hanneke W. M. van Grieken, Nicole C. T. Verheij, Marcel Gastric Cancer Original Article AIM: To evaluate the prognostic value of tumor markers in a European cohort of patients with resectable gastric cancer. METHODS: We performed a post hoc analysis of the CRITICS trial, in which 788 patients received perioperative therapy. Association between survival and pretreatment CEA, CA 19-9, alkaline phosphatase, neutrophils, hemoglobin and lactate dehydrogenase were explored in uni- and multivariable Cox regression analyses. Likelihoods to receive potentially curative surgery were investigated for patients without elevated tumor markers versus one of the tumor markers elevated versus both tumor markers elevated. The association between tumor markers and the presence of circulating tumor DNA (ctDNA) was explored in 50 patients with available ctDNA data. RESULTS: In multivariable analysis, in which we corrected for allocated treatment and other baseline characteristics, elevated pretreatment CEA (HR 1.43; 95% CI 1.11–1.85, p < 0.001) and CA 19-9 (HR 1.79; 95% CI 1.42–2.25, p < 0.001) were associated with worse OS. Likelihoods to receive potentially curative surgery were 86%, 77% and 60% for patients without elevated tumor marker versus either elevated CEA or CA 19-9 versus both elevated, respectively (p < 0.001). Although both preoperative presence of ctDNA and tumor markers were prognostic for survival, no association was found between these two parameters. CONCLUSION: CEA and CA 19-9 were independent prognostic factors for survival in a large cohort of European patients with resectable gastric cancer. No relationship was found between tumor markers and ctDNA. These factors could potentially guide treatment choices and should be included in future trials to determine their definitive position. TRIAL REGISTRATION: ClinicalTrial.gov identifier: NCT00407186. EudraCT number: 2006-00413032. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10120-021-01258-6. Springer Singapore 2021-10-29 2022 /pmc/articles/PMC8882113/ /pubmed/34714423 http://dx.doi.org/10.1007/s10120-021-01258-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Slagter, Astrid E. Vollebergh, Marieke A. Caspers, Irene A. van Sandick, Johanna W. Sikorska, Karolina Lind, Pehr Nordsmark, Marianne Putter, Hein Braak, Jeffrey P. B. M. Meershoek-Klein Kranenbarg, Elma van de Velde, Cornelis J. H. Jansen, Edwin P. M. Cats, Annemieke van Laarhoven, Hanneke W. M. van Grieken, Nicole C. T. Verheij, Marcel Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial |
title | Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial |
title_full | Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial |
title_fullStr | Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial |
title_full_unstemmed | Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial |
title_short | Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment: results from the CRITICS trial |
title_sort | prognostic value of tumor markers and ctdna in patients with resectable gastric cancer receiving perioperative treatment: results from the critics trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882113/ https://www.ncbi.nlm.nih.gov/pubmed/34714423 http://dx.doi.org/10.1007/s10120-021-01258-6 |
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