Transient increases in serum α fetoprotein and protein induced by vitamin K antagonist II levels following proton therapy does not necessarily indicate progression of hepatocellular carcinoma

Abstract

that in the flare-negative group (P=0.015, odds ratio 4.3, 95% confidence interval, 1.3-14.0). In the 23 patients with out-of-field recurrence, the median increase rate of PIVKA-II (203%) was higher than that in the PIVKA-II-flare-positive group (111%, P= 0.035) and the time to recurrence (median, 9 months) was longer than the time to peak AFP level (1 month) in the AFP-flare-positive group (P=0.033). There was no significant association between flares and clinical response. Increases in AFP and PIVKA-II levels following PT should be assessed with caution to avoid misinterpretation of therapeutic outcome.

Transient Changes in Serum CEA, CA19-9, CRP, YKL-40, and IL-6 during Adjuvant Chemotherapy and Survival of Patients with Colorectal Cancer

“…A transient increase in the serum CA19-9 during a treatment for mCRC [ 38 ] and in serum TIMP-1 during an adjuvant treatment of CRC [ 30 ] have been described, but these findings were not correlated with the outcome. A transient increase in the serum CEA and CA15-3 may occur in patients with metastatic breast cancer that are receiving systemic chemotherapy [ 46 ], and similar surges of serum biomarkers have been demonstrated in patients with a hepatocellular carcinoma regarding α-fetoprotein [ 47 ], in patients with a testicular germ cell tumour with human chorionic gonadotropin [ 48 ], and in patients with metastatic gastric cancer with CEA and CA19-9 [ 49 ], mostly predicting the clinical benefits of chemotherapy.…”

PIVKA-II as a surrogate marker for prognosis in patients with localized hepatocellular carcinoma receiving stereotactic body radiotherapy

“…In this study, AFP normalization was defined as an AFP level of 20 ng/ml or less. On the contrary, there is a report that transient increases in AFP or PIVKA-II levels at 12 months follow-up after proton therapy (PT) were not statistically significantly associated with treatment response because tumor lysis, acute hepatitis, or cell regeneration could induce elevation [ 8 ]. In a meta-analysis of 29 studies that were stratified by AFP response after treatment, AFP response after various treatments could be a useful prognostic factor for HCC patients [ 21 ].…”