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Monitoring of CA19-9 and SPan-1 can facilitate the earlier confirmation of progressing pancreatic cancer during chemotherapy . BACKGROUND Measurement of objective response to chemotherapy using imaging modalities is sometimes difficult in pancreatic cancer ( PC ) . We aimed to verify whether monitoring of serum tumor markers ( TMs ) , namely carcinoembryonic antigen , CA19-9 , DUPAN-2 , SPan-1 , can facilitate earlier confirmation of treatment failure . METHODS Monitoring of serum TMs and computed tomography were performed every 4 weeks until progression of disease in 90 patients with PC undergoing gemcitabine therapy . In Group A ( January 2006-October 2007 ) , we analyzed the fluctuation rates of TMs with high pretreatment positive rates , and defined the criteria of progressive disease under TM monitoring ( TM-PD ) . In Group B ( November 2007-October 2008 ) , we calculated the time to progression ( TTP ) under this TM-PD criteria , which was compared with the TTP under the RECIST criteria . RESULTS CA19-9 and SPan-1 had the highest pretreatment positive rates : 83 % and 90 % , respectively . In Group A ( CA19-9 , n = 38 ; SPan-1 , n = 36 ) , TM-PD criteria were defined as follows : fluctuation rates were ≥25 % for a month or ≥10 % for 2 consecutive months in CA19-9 , and ≥10 % for a month in SPan-1 . In Group B ( CA19-9 , n = 18 ; SPan-1 , n = 17 ) , under these criteria , one-month earlier confirmation of treatment failure was feasible in 61 % by CA19-9 and 59 % by SPan-1 . Furthermore , the combination could facilitate this determination in 72 % ( 35/49 ) , significantly better than CA19-9 alone ( P = 0.004 ) . CONCLUSION Monitoring of serum CA19-9 and SPan-1 is helpful for earlier confirmation of treatment failure during gemcitabine therapy in PC .
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Intervention_Physical
Monitoring of serum TMs and computed tomography were performed every 4 weeks until progression of disease
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Intervention_Physical
fluctuation rates of TMs with high pretreatment positive rates , and defined the criteria of progressive disease under TM monitoring ( TM-PD )
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Intervention_Physical
time to progression ( TTP ) under this TM-PD criteria , which was compared with the TTP under the RECIST criteria
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Outcome_Physical
objective response to chemotherapy
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Outcome_Other
using imaging modalities
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Outcome_Physical
serum tumor markers ( TMs )
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Outcome_Physical
namely carcinoembryonic antigen , CA19-9
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Outcome_Physical
DUPAN-2
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Outcome_Physical
SPan-1
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Outcome_Physical
serum TMs
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Outcome_Other
computed tomography
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Outcome_Physical
fluctuation rates of TMs
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Outcome_Physical
time to progression ( TTP )
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Participant_Condition
pancreatic cancer ( PC )
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Participant_Sample-size
90
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Participant_Condition
PC
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Participant_Condition
gemcitabine therapy