ArticleCancer2013
Carbohydrate antigen 19-9 is a prognostic and predictive biomarker in patients with advanced pancreatic cancer who receive gemcitabine-containing chemotherapy: a pooled analysis of 6 prospective trials.
Article in Cancer, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
70 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical practice guidelines for molecular tumor marker, 2nd edition review part 2.International journal of clinical oncology · 2024Guideline
- Clinicopathologic and Prognostic Value of Serum Carbohydrate Antigen 19-9 in Gastric Cancer: A Meta-Analysis.Disease markers · 2015Pooled it
- CA19-9 and CA242 as tumor markers for the diagnosis of pancreatic cancer: a meta-analysis.Clinical and experimental medicine · 2014Pooled it
- A Randomized Phase II Preoperative Study of Autophagy Inhibition with High-Dose Hydroxychloroquine and Gemcitabine/Nab-Paclitaxel in Pancreatic Cancer Patients.Clinical cancer research : an official journal of the American Association for Cancer Research · 2020Trial
- Change in carbohydrate antigen 19-9 level as a prognostic marker of overall survival in locally advanced pancreatic cancer treated with concurrent chemoradiotherapy.International journal of clinical oncology · 2017Trial
- CA19-9 decrease at 8 weeks as a predictor of overall survival in a randomized phase III trial (MPACT) of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic pancreatic cancer.Annals of oncology : official journal of the European Society for Medical Oncology · 2016Trial
- Trial
- Safety and Biologic Response of Pre-operative Autophagy Inhibition in Combination with Gemcitabine in Patients with Pancreatic Adenocarcinoma.Annals of surgical oncology · 2015Trial
- Prognostic factors of survival in a randomized phase III trial (MPACT) of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone in patients with metastatic pancreatic cancer.The oncologist · 2015Trial
- Pharmacogenomic profiling of the efficacy of gemcitabine monotherapy in metastatic pancreatic cancer: Subgroup analysis of the GENESECT study.British journal of clinical pharmacology · 2026Article
- Association between ABCB1 genetic polymorphisms with treatment outcomes in patients with metastatic pancreatic cancer.International journal of clinical oncology · 2026Article
- The post-neoadjuvant absolute lymphocyte count reflects the pathological response and local tumor control in pancreatic cancer.Surgery today · 2026Article
- Article
- To Evaluate Whether Pretreatment CA19-9 and DUPAN-2 Levels Can Serve as Predictive Markers to Guide the Choice Between NAT and Upfront Surgery in Pancreatic Cancer.Annals of gastroenterological surgery · 2026Article
- Article
- Case Report: Long-term remission of metastatic pancreatic ductal adenocarcinoma after surgery and high-dose nicotinamide supplementation.Frontiers in oncology · 2026Article
- Article
- CA19-9 as a Dynamic Biomarker for Continuous Monitoring of Therapeutic Efficacy in Pancreatic Adenocarcinoma.Cancers · 2025Review
- Predictive and prognostic factors of efficacy of third-line chemotherapy in patients with unresectable pancreatic cancer: a cohort-based study.The oncologist · 2025Article
- Survival Outcomes According to NCCN Criteria for Resection Following Neoadjuvant Therapy for Patients with Localized Pancreatic Cancer.Annals of surgical oncology · 2025Article
10 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors.
Funding
Abstract
backgroundCarbohydrate antigen 19-9 (CA19-9) is a widely used biomarker in pancreatic cancer. There is no consensus on the interpretation of the change in CA19-9 serum levels and its role in the clinical management of patients with pancreatic cancer.
methodsIndividual patient data from 6 prospective trials evaluating gemcitabine-containing regimens from 3 different institutions were pooled. CA19-9 values were obtained at baseline and after successive cycles of treatment. The objective of this study was to correlate a decline in CA19-9 with outcomes while undergoing treatment.
resultsA total of 212 patients with locally advanced (n = 50) or metastatic (n = 162) adenocarcinoma of the pancreas were included. Median baseline CA19-9 level was 1077 ng/mL (range, 15-492,241 ng/mL). Groups were divided into those levels below (low) or above (high) the median. Median overall survival (mOS) was 8.7 versus 5.2 months (P = .0018) and median time to progression (mTTP) was 5.8 versus 3.7 months (P = .082) in the low versus high groups, respectively. After 2 cycles of chemotherapy, up to a 5% increase versus ≥ 5% increase in CA19-9 levels conferred an improved mOS (10.3 vs 5.1 months, P = .0022) and mTTP (7.5 vs 3.5 months, P = 0.0005).
conclusionsIn patients who have advanced pancreatic cancer treated with gemcitabine-containing regimens baseline CA19-9 is prognostic for outcome. A decline in CA19-9 after the second cycle of chemotherapy is not predictive of improved mOS or mTTP; thus, CA19-9 decline is not a useful surrogate endpoint in clinical trials. Clinically, a ≥ 5% rise in CA19-9 after 2 cycles of chemotherapy serves as a negative predictive marker.
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