Evidence map›Paper›PMID 39905306›Full record

Trial reportBMC gastroenterology2025

Collagen turnover biomarkers to predict outcome of patients with biliary cancer.

Leonard Kaps, Muhammed A Genc, Markus Moehler, Stephan Grabbe, Jörn M Schattenberg, Detlef Schuppan, Rasmus Sund Pedersen, Morten A Karsdal, Philipp Mildenberger, Annett Maderer and 1 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00661830 (A Randomized, Double-blind, Multicenter Phase II Trial With Gemcitabine Plus Sorafenib Versus Gemcitabine Plus Placebo in Patients With Chemo-naive Advanced or Metastatic Adenocarcinoma of the Biliary Tract), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT00661830 phase2completednot on this map

A Randomized, Double-blind, Multicenter Phase II Trial With Gemcitabine Plus Sorafenib Versus Gemcitabine Plus Placebo in Patients With Chemo-naive Advanced or Metastatic Adenocarcinoma of the Biliary Tract

TypeinterventionalSponsorPD Dr Markus MöhlerRan2008 to 2010Enrolled103ConditionsAdenocarcinomaArmsGemcitabine, Placebo, Sorafenib
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Type VIII collagen: advances in matrix biology and translational promise.Frontiers in bioengineering and biotechnology · 2025
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Review
  7. The Duality of Collagens in Metastases of Solid Tumors.International journal of molecular sciences · 2025
    Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Leonard Kaps *Department of Dermatology, University Medical Center of the Johannes Gutenberg-University, Mainz, 55128, Germany. leonard.kaps@uks.eu.
Muhammed A GencFirst Department of Medicine, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany.
Markus MoehlerFirst Department of Medicine, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany.
Stephan GrabbeDepartment of Dermatology, University Medical Center of the Johannes Gutenberg-University, Mainz, 55128, Germany.
Jörn M SchattenbergDepartment of Medicine II, Saarland University Medical Center, Saarland University, Homburg, 66421, Germany.
Detlef SchuppanUniversity Medical Center, Institute of Translational Immunology and Research Center for Immunotherapy, Johannes Gutenberg-University, Mainz, Germany.
Rasmus Sund PedersenNordic Bioscience A/S, 2730, Herlev, Denmark.
Morten A KarsdalNordic Bioscience A/S, 2730, Herlev, Denmark.
Philipp MildenbergerInstitute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Annett Maderer *First Department of Medicine, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany. annett.maderer@unimedizin-mainz.de.
Nicholas Willumsen *Nordic Bioscience A/S, 2730, Herlev, Denmark. nwi@NordicBio.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe collagen-rich tumor stroma plays a crucial role in biliary tract cancer (BTC). Collagen biomarkers of type I collagen (reC1M), type III collagen (PRO-C3), type IV collagen (C4G), type VIII collagen (PRO-C8), type XI collagen (PRO-C11), type XVII collagen (PRO-C17) and type VIII collagen (TUM) may be used as potential non-invasive biomarkers.

methodsWe measured the seven biomarkers of collagen turnover in sera of 72 patients with BTC at baseline and after first and second chemotherapy cycle (CTX). Markers were also assessed in sera of 50 healthy controls and compared to levels of patients at baseline. The diagnostic and prognostic value of the markers was evaluated for overall survival (OS) and progression-free survival (PFS).

resultsPatients had a median age of 65 years (IQR 57-70), while healthy controls were younger, with a median age of 46 years (IQR 38-54). The majority of patients (62%) were diagnosed with intrahepatic bile duct adenocarcinoma. Except C4G, all collagen turnover markers were significantly (p < 0.001) increased in serum from patients with BTC compared to healthy controls. PRO-C3 was the best marker to discriminate between patients with BTC and controls, reaching an area under a receiver operating characteristic (AUROC) of 0.98 (95% CI 0.95; 0.99) with a sensitivity (92%) and specificity (94%) balanced cutoff of 77.3 ng/ml. Patients with high levels (cohort separated by median split) of PRO-C8 (HR 2.85, 95% CI 1.42; 5.73) followed by C3M (HR 2.33, 95% CI 1.2; 4.5), PRO-C3 (HR 3.09, 95% CI 1.5; 6.36) and CA 19-9 (HR 2.52, 95% CI 1.37; 4.64) as reference biomarker had a shorter OS. Notably, only the novel marker PRO-C8 was also predictive of PFS (HR 3.26, 95% CI 1.53; 6.95). Associations with survival outcomes remained significant after adjusting for relevant risk factors (CA 19-9 and CEA at baseline, age, presence of metastases, weight, height and gender).

conclusionThe collagen turnover markers PRO-C8, C3M, PRO-C3 and the established biomarker CA 19-9 were prognostic for OS in patients with BTC while only PRO-C8 was also predictive for PFS. PRO-C3 showed the best diagnostic performance to discriminate between patients with BTC and controls.

trial registrationTrial registration number and date of registration NCT00661830 (NCT number) 15 April 2008 Trial registry The complete registry can found under: https://clinicaltrials.gov/study/NCT00661830?tab=table#administrative-information (last accessed 01/2025) Principal investigator and study sponsor Markus Moehler, MD Johannes Gutenberg University Mainz.

Indexed as

AdenocarcinomaBile Duct NeoplasmsBiliary Tract NeoplasmsBiomarkers, TumorCollagenAdultAgedCase-Control StudiesCholangiocarcinomaCollagen Type ICollagen Type IIICollagen Type IVCollagen Type VIIIFemaleHumansMaleBiomarkers, TumorCollagenCollagen Type ICollagen Type IIICollagen Type IVCollagen Type VIIIExtracellular matrixGastrointestinal cancerTumor marker

Identifiers

PMID39905306
PMCPMC11792424

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.