Assessing prognosis in metastatic pancreatic cancer by the serum tumor marker CA 19-9: Pretreatment levels or kinetics during chemotherapy?

Background: The carbohydrate antigen 19-9 (CA 19-9) is currently
the most widely used serum tumor marker in pancreatic cancer (PC).
CA 19-9 pretreatment levels as well as CA 19-9 kinetics during
systemic chemotherapy can provide prognostic information regarding
survival of patients with metastatic PC. Case Reports: We report
the clinical course of 2 patients with metastatic PC who underwent
palliative chemotherapy with gemcitabine. Both patients showed a
significant elevation of pretreatment CA 19-9 levels (7,505 and
150,000 U/ml, respectively), however, subsequently they experienced
a highly significant reduction (> 90%) of CA 19-9 kinetics under
gemcitabine chemotherapy. A good disease control and a clinical
benefit response were achieved in both patients. Time to tumor
progression was 30 weeks and 28 weeks, overall survival 14 months
and 11 months, respectively. Conclusion: These data indicate that
CA 19-9 kinetics under chemotherapy may possibly serve as a useful
surrogate marker for time to tumor progression and survival in
advanced PC.