Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review
Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment : results from the CRITICS trial. / Slagter, Astrid E.; Vollebergh, Marieke A.; Caspers, Irene A. et al.
I: Gastric Cancer, Bind 25, Nr. 2, 03.2022, s. 401-410.Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review
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TY - JOUR
T1 - Prognostic value of tumor markers and ctDNA in patients with resectable gastric cancer receiving perioperative treatment
T2 - results from the CRITICS trial
AU - Slagter, Astrid E.
AU - Vollebergh, Marieke A.
AU - Caspers, Irene A.
AU - van Sandick, Johanna W.
AU - Sikorska, Karolina
AU - Lind, Pehr
AU - Nordsmark, Marianne
AU - Putter, Hein
AU - Braak, Jeffrey P.B.M.
AU - Meershoek-Klein Kranenbarg, Elma
AU - van de Velde, Cornelis J.H.
AU - Jansen, Edwin P.M.
AU - Cats, Annemieke
AU - van Laarhoven, Hanneke W.M.
AU - van Grieken, Nicole C.T.
AU - Verheij, Marcel
N1 - Publisher Copyright: © 2021, The Author(s).
PY - 2022/3
Y1 - 2022/3
N2 - Aim: To evaluate the prognostic value of tumor markers in a European cohort of patients with resectable gastric cancer. Methods: We performed a post hoc analysis of the CRITICS trial, in which 788 patients received perioperative therapy. Association between survival and pretreatment CEA, CA 19-9, alkaline phosphatase, neutrophils, hemoglobin and lactate dehydrogenase were explored in uni- and multivariable Cox regression analyses. Likelihoods to receive potentially curative surgery were investigated for patients without elevated tumor markers versus one of the tumor markers elevated versus both tumor markers elevated. The association between tumor markers and the presence of circulating tumor DNA (ctDNA) was explored in 50 patients with available ctDNA data. Results: In multivariable analysis, in which we corrected for allocated treatment and other baseline characteristics, elevated pretreatment CEA (HR 1.43; 95% CI 1.11–1.85, p < 0.001) and CA 19-9 (HR 1.79; 95% CI 1.42–2.25, p < 0.001) were associated with worse OS. Likelihoods to receive potentially curative surgery were 86%, 77% and 60% for patients without elevated tumor marker versus either elevated CEA or CA 19-9 versus both elevated, respectively (p < 0.001). Although both preoperative presence of ctDNA and tumor markers were prognostic for survival, no association was found between these two parameters. Conclusion: CEA and CA 19-9 were independent prognostic factors for survival in a large cohort of European patients with resectable gastric cancer. No relationship was found between tumor markers and ctDNA. These factors could potentially guide treatment choices and should be included in future trials to determine their definitive position. Trial registration: ClinicalTrial.gov identifier: NCT00407186. EudraCT number: 2006-00413032.
AB - Aim: To evaluate the prognostic value of tumor markers in a European cohort of patients with resectable gastric cancer. Methods: We performed a post hoc analysis of the CRITICS trial, in which 788 patients received perioperative therapy. Association between survival and pretreatment CEA, CA 19-9, alkaline phosphatase, neutrophils, hemoglobin and lactate dehydrogenase were explored in uni- and multivariable Cox regression analyses. Likelihoods to receive potentially curative surgery were investigated for patients without elevated tumor markers versus one of the tumor markers elevated versus both tumor markers elevated. The association between tumor markers and the presence of circulating tumor DNA (ctDNA) was explored in 50 patients with available ctDNA data. Results: In multivariable analysis, in which we corrected for allocated treatment and other baseline characteristics, elevated pretreatment CEA (HR 1.43; 95% CI 1.11–1.85, p < 0.001) and CA 19-9 (HR 1.79; 95% CI 1.42–2.25, p < 0.001) were associated with worse OS. Likelihoods to receive potentially curative surgery were 86%, 77% and 60% for patients without elevated tumor marker versus either elevated CEA or CA 19-9 versus both elevated, respectively (p < 0.001). Although both preoperative presence of ctDNA and tumor markers were prognostic for survival, no association was found between these two parameters. Conclusion: CEA and CA 19-9 were independent prognostic factors for survival in a large cohort of European patients with resectable gastric cancer. No relationship was found between tumor markers and ctDNA. These factors could potentially guide treatment choices and should be included in future trials to determine their definitive position. Trial registration: ClinicalTrial.gov identifier: NCT00407186. EudraCT number: 2006-00413032.
KW - CA 19-9
KW - CEA
KW - ctDNA
KW - Resectable gastric cancer
KW - Tumor markers
UR - http://www.scopus.com/inward/record.url?scp=85118406843&partnerID=8YFLogxK
U2 - 10.1007/s10120-021-01258-6
DO - 10.1007/s10120-021-01258-6
M3 - Journal article
C2 - 34714423
AN - SCOPUS:85118406843
VL - 25
SP - 401
EP - 410
JO - Gastric Cancer
JF - Gastric Cancer
SN - 1436-3291
IS - 2
ER -