ASCO 2006 Update of Recommendations for the Use of Tumor Markers in Gastrointestinal Cancer

Abstract

For colorectal cancer, it is recommended that carcinoembryonic antigen (CEA) be ordered preoperatively, if it would assist in staging and surgical planning. Postoperative CEA levels should be performed every 3 months for stage II and III disease for at least 3 years if the patient is a potential candidate for surgery or chemotherapy of metastatic disease. CEA is the marker of choice for monitoring the response of metastatic disease to systemic therapy. Data are insufficient to recommend the routine use of p53, ras, thymidine synthase, dihydropyrimidine dehydrogenase, thymidine phosphorylase, microsatellite instability, 18q loss of heterozygosity, or deleted in colon cancer (DCC) protein in the management of patients with colorectal cancer. For pancreatic cancer, CA 19-9 can be measured every 1 to 3 months for patients with locally advanced or metastatic disease receiving active therapy. Elevations in serial CA 19-9 determinations suggest progressive disease but confirmation with other studies should be sought. New markers and new evidence to support the use of the currently reviewed markers will be evaluated in future updates of these guidelines.

Impacts of excision repair cross-complementing gene 1 (ERCC1), dihydropyrimidine dehydrogenase, and epidermal growth factor receptor on the outcomes of patients with advanced gastric cancer

“…Recently, several studies have reported that patients' genetic profiles are related to the outcomes of cancer therapy (van 't Veer et al, 2002;Ruzzo et al, 2006). In colorectal cancer, since many studies have examined molecular predictors of outcomes during the past decade, TS, DPD, and TP were newly included in 'ASCO 2006 tumour marker guidelines in gastrointestinal cancer' (Locker et al, 2006). Because sufficient supporting evidence is lacking, however, the guidelines recommend that these biomarkers should not yet be used clinically to predict prognosis or treatment response.…”

Immune Cells in Colorectal Cancer: Prognostic Relevance and Role of MSI

“…Genetic and molecular tumor prognostic factors have been proposed to identify patients who may be at risk for recurrence. None of these however, have been sufficiently informative for inclusion in clinical practice [9].…”

Complete pathological response to bevacizumab and chemoradiation in advanced rectal cancer

“…23 Patients with a preoperative serum CEA greater than 5 ng/ml seem to have a worse prognosis, stage for stage, than those with lower CEA levels. In this patient, the immunohistochemical, plasma protein and circulating-cell data revealed interesting patterns at baseline and changes with treatment.…”