Prognostic and therapeutic significance of carbohydrate antigen 19-9 as tumor marker in patients with pancreatic cancer

In pancreatic cancer ( PC) accurate determination of treatment
response by imaging often remains difficult. Various efforts have
been undertaken to investigate new factors which may serve as more
appropriate surrogate parameters of treatment efficacy. This review
focuses on the role of carbohydrate antigen 19- 9 ( CA 19- 9) as a
prognostic tumor marker in PC and summarizes its contribution to
monitoring treatment efficacy. We undertook a Medline/ PubMed
literature search to identify relevant trials that had analyzed the
prognostic impact of CA 19- 9 in patients treated with surgery,
chemoradiotherapy and chemotherapy for PC. Additionally, relevant
abstract publications from scientific meetings were included. In
advanced PC, pretreatment CA 19- 9 levels have a prognostic impact
regarding overall survival. Also a CA 19- 9 decline under
chemotherapy can provide prognostic information for median
survival. A 20% reduction of CA 19- 9 baseline levels within the
first 8 weeks of chemotherapy appears to be sufficient to define a
prognostic relevant subgroup of patients ('CA 19- 9 responder'). It
still remains to be defined whether the CA 19- 9 response is a more
reliable method for evaluating treatment efficacy compared to
conventional imaging. Copyright (c) 2006 S. Karger AG, Basel.