Carbohydrate antigen 19-9 — tumor marker: Past, present, and future

The Prognostic Significance of Novel Pancreas Cancer Prognostic Index in Unresectable Locally Advanced Pancreas Cancers Treated with Definitive Concurrent Chemoradiotherapy

“…Despite recognizing the difficulties in the comparison of studies with different methodologies, the individual median and 5-year PFS and OS results of the current retrospective cohort analysis in 152 LAPAC patients treated with definitive C-CRT accord well with previous C-CRT reports in these patients. 18,19,37,38 Besides, results from multivariate analyses appeared to strengthen previously established independent unfavorable prognostic influence of the N 1-2 stage, presenting WL>5%, CA19-9 > 90 U/mL, and SIRI>1.6. However, the chief contribution of our critical research to the LAPAC literature was the display of the PCPI (a blend of CA 19-9 and SIRI) as an innovative and independent prognostic factor that uniquely merges a tumor marker and an immune-inflammation biomarker that efficiently stratifies the LAPAC patients into three unique PFS and OS groups beyond that of accessible prognosticators following radical C-CRT.…”

“…3,7,9,10,[31][32][33]35 Similarly, CA 19-9 has been extensively studied for its prognostic significance in PAC patients undergoing various oncological treatments, with proven efficacy for accurate prediction of pretreatment tumor stage and resectability status, response to therapy, PFS, and OS outcomes, despite various cutoffs being used in these researches. [16][17][18][19][20][21][22][23] Surprisingly, establishing rational grounds for the present investigation, the blend of these two potent biomarkers had never been tested before for its prognostic significance in unresectable LAPAC patients who underwent exclusive C-CRT albeit SIRI was first formulated for PAC patients and the CA 19-9 demonstrates its chief utility in PACs.…”

“…[11][12][13][14][15][16][17] However, given that its primary implications were discovered for PACs, the CA 19-9 prevails as an essential biomarker in routine clinical use for the diagnosis, staging, management, and prognostication of PAC patients undergoing various anti-cancer treatments. [16][17][18] Concerning the prognostic value of CA 19-9, several investigations have found a significant association between the diminished survival results and higher CA 19-9 levels, even though variable cutoffs were adopted in these studies. [19][20][21][22][23] In this respect, the researchers of the benchmark Charité Onkologie 001 (CONKO-001) randomized trial used the CA 19-9 ≤ 90 U/mL threshold level for eligibility in their study, which compared adjuvant chemotherapy with gemcitabine against observation in 368 patients undergoing curative-intent resection of PACs.…”

UEG position paper on pancreatic cancer. Bringing pancreatic cancer to the 21st century: Prevent, detect, and treat the disease earlier and better

“…Identifying biomarkers in body fluids (liquid biopsies) for early PDAC or preinvasive precursors with potential for malignant transformation is the holy grail in pancreatic cancer research. Although the tumor marker CA 19‐9 has a low sensitivity, it is the best available marker for PDAC to date 36 . Increase in CA 19‐9, even if still in the normal range (<35 u/ml), is indicative of a progress in IPMN 37 and indication for surgery 38 .…”

Dynamic Stromal Alterations Influence Tumor-Stroma Crosstalk to Promote Pancreatic Cancer and Treatment Resistance

“…PDAC has a paucity of specific and sensitive biomarkers, with carbohydrate antigen 19-9 (CA19-9) being the only routine biomarker used in the clinic [ 59 , 60 ]. Unfortunately, CA19-9 is not highly specific to PDAC (only found in the serum of ~75% of patients) and is also secreted in other conditions such as benign pancreatic diseases (e.g., pancreatitis) and other cancers [ 61 ]. Considering the stromal density and extensive ECM turnover in PDAC tumors, it is logical that using ECM-based biomarkers could potentially help during diagnosis of the disease.…”