Trial reportJournal of cancer research and clinical oncology2013
Prognostic value of CA 19-9, CEA, CRP, LDH and bilirubin levels in locally advanced and metastatic pancreatic cancer: results from a multicenter, pooled analysis of patients receiving palliative chemotherapy.
Trial report in Journal of cancer research and clinical oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 3 of them syntheses that pooled it.
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The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Systematic review of peri-operative prognostic biomarkers in pancreatic ductal adenocarcinoma.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2016Pooled it
- Glucose metabolic phenotype of pancreatic cancer.World journal of gastroenterology · 2016Pooled it
- Prognostic Role of Carbohydrate Antigen 19 to 9 in Predicting Survival of Patients With Pancreatic Cancer: A Meta-Analysis.Technology in cancer research & treatmentPooled it
- Plasma YKL-40 is associated with prognosis in patients with metastatic pancreatic cancer receiving immune checkpoint inhibitors in combination with radiotherapy.Frontiers in immunology · 2023Trial
- 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
- Randomised, open-label, phase II study of gemcitabine with and without IMM-101 for advanced pancreatic cancer.British journal of cancer · 2016Trial
- Pharmacokinetics of ixazomib, an oral proteasome inhibitor, in solid tumour patients with moderate or severe hepatic impairment.British journal of clinical pharmacology · 2016Trial
- Prognostic value of health-related quality of life in patients with metastatic pancreatic adenocarcinoma: a random forest methodology.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2016Trial
- Trial
- Article
- The Prognostic Value of the EASIX Score in Patients with Metastatic Pancreatic Cancer.Diagnostics (Basel, Switzerland) · 2025Article
- Prognostic value of neutrophil to lymphocyte ratio in patients with advanced pancreatic ductal adenocarcinoma treated with systemic chemotherapy.Annals of medicine · 2024Article
- Brown-Colored Malignant Pleural Fluid With High Bilirubin Levels: A Case Series.Case reports in pulmonology · 2024Article
- Predictive Value of the Total Bilirubin and CA50 Screened Based on Machine Learning for Recurrence of Bladder Cancer Patients.Cancer management and research · 2024Article
- A machine learning model based on clinical features and ultrasound radiomics features for pancreatic tumor classification.Frontiers in endocrinology · 2024Article
- New model to predict survival in advanced pancreatic ductal adenocarcinoma patients by measuring GGT and LDH levels and monocyte count.Frontiers in oncology · 2024Article
- Beta-human chorionic gonadotropin, carbohydrate antigen 19-9, cancer antigen 125, and carcinoembryonic antigen as prognostic and predictive biological markers in bladder cancer.Frontiers in oncology · 2024Article
- Isolated pulmonary metastases in pancreatic ductal adenocarcinoma: a review of current evidence.Cancer biology & therapy · 2023Review
- Serum biomarker panel diagnostics in pancreatic ductal adenocarcinoma: the clinical utility of soluble interleukins, IFN-γ, TNF-α and PD-1/PD-L1 in comparison to established serum tumor markers.Journal of cancer research and clinical oncology · 2023Article
- Structured deep embedding model to generate composite clinical indices from electronic health records for early detection of pancreatic cancer.Patterns (New York, N.Y.) · 2023Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCA 19-9 is the only established tumor marker in pancreatic cancer (PC); the prognostic role of other serum markers like CEA, CRP, LDH or bilirubin has not yet been defined.
methodsWe pooled pre-treatment data on CA 19-9, CEA, CRP, LDH and bilirubin levels from two German multicenter randomized phase II trials together with prospective patient data from one high-volume German Cancer Center. Marker levels were assessed locally before the start of palliative first-line therapy for advanced PC and serially during treatment (for CA 19-9 only). Clinical and biomarker data (overall 12 variables) were correlated with the efficacy endpoints time-to-progression (TTP) and overall survival (OS) by using uni- and multivariate Cox models.
resultsData from 291 patients were included in this pooled analysis; 253 patients (87 %) received treatment within prospective clinical trials. Median TTP in the study cohort was 5.1 months and median OS 9.0 months. In univariate analysis, pre-treatment CA 19-9 (HR 1.55), LDH (HR 2.04) and CEA (HR 1.89) levels were significantly associated with TTP. Regarding OS, baseline CA 19-9 (HR 1.46), LDH (HR 2.07), CRP (HR 1.69) and bilirubin (HR 1.62) were significant prognostic factors. Within multivariate analyses, pre-treatment log [CA 19-9] (as continuous variable for TTP) and log [bilirubin] as well as log [CRP] (for OS) had an independent prognostic value. A CA 19-9 decline of ≥25 % during the first two chemotherapy cycles was predictive for TTP and OS, independent of the applied CA 19-9 assay.
conclusionBaseline CA 19-9 and CA 19-9 kinetics during first-line chemotherapy are prognostic in advanced PC. Besides that finding other serum markers like CRP, LDH and bilirubin can also provide prognostic information on TTP and OS.
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