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Clinical Significance of Discordance between Carcinoembryonic Antigen Levels and RECIST in Metastatic Colorectal Cancer
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In-Ho Kim, Ji Eun Lee, Ji Hyun Yang, Joon Won Jeong, Sangmi Ro, Seong Taek Oh, Jun-Gi Kim, Moon Hyung Choi, Myung Ah Lee
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Cancer Res Treat. 2018;50(1):283-292. Published online May 8, 2017
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DOI: https://doi.org/10.4143/crt.2016.537
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 Abstract
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- Purpose
The purpose of this study was to investigate the prognostic implications of carcinoembryonic antigen (CEA) levels that are inconsistent with Response Evaluation Criteria in Solid Tumor (RECIST) responses in metastatic colorectal cancer patients.
Materials and Methods
We retrospectively evaluated 360 patients with at least one measurable lesion who received first-line palliative chemotherapy. CEA-response was defined as CEA-complete response (CR; CEA normalization), CEA-partial response (PR; ≥ 50% decrease in CEA levels), CEA-progressive disease (PD; ≥ 50% increase in CEA levels), and CEA-stable disease (SD; non-CR/PR/PD). Overall survival (OS) and progression-free survival (PFS) were evaluated according to CEA-response.
Results
In RECIST-PR patients, poorer CEA-response was associated with disease progression at the subsequent evaluation. In RECIST-SD patients, CEA-CR and -PR were associated with lower disease progression rates than CEA-PD at the subsequent evaluation. Correlations between survival outcome and CEA-response in same-category RECIST patients were assessed. In RECIST-PR patients, discordant CEA-response (CEA-PD/SD) was associated with poorer survival than CEA-CR/PR (median OS and PFS, 44.0 and 15.4 [CEA-CR], 28.9 and 12.5 [CEA-PR], 21.0 and 9.8 [CEA-SD], and 13.0 and 7.0 [CEA-PD] months, respectively; all p < 0.001). In RECIST-SD patients, favorable CEA-response produced better survival (median OS and PFS, 26.8 and 21.0 [CEA-CR], 21.0 and 11.0 [CEA-PR], 16.1 and 8.2 [CEA-SD], and 12.2 and 6.0 [CEA-PD] months, respectively; all p < 0.001). RECIST-PD patients with CEA-CR showed longer OS than those with CEA-PD. Multivariate analysis demonstrated that discordant CEA-response is a powerful prognostic factor for RECIST-PR and RECIST-SD patients.
Conclusion
Among patients of the same RECIST-response categories, CEA-response patterns are significantly prognostic and strongly predictive of subsequent evaluation outcomes.
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Citations
Citations to this article as recorded by  - Presence of CD44v9-Expressing Cancer Stem Cells in Circulating Tumor Cells and Effects of Carcinoembryonic Antigen Levels on the Prognosis of Colorectal Cancer
Katsuji Sawai, Takanori Goi, Youhei Kimura, Kenji Koneri
Cancers.2024; 16(8): 1556. CrossRef - Dynamic monitoring of carcinoembryonic antigen, CA19-9 and inflammation-based indices in patients with advanced colorectal cancer undergoing chemotherapy
Nebojsa Manojlovic, Goran Savic, Bojan Nikolic, Nemanja Rancic
World Journal of Clinical Cases.2022; 10(3): 899. CrossRef - Current Applications and Discoveries Related to the Membrane Components of Circulating Tumor Cells and Extracellular Vesicles
Luis Enrique Cortés-Hernández, Zahra Eslami-S, Bruno Costa-Silva, Catherine Alix-Panabières
Cells.2021; 10(9): 2221. CrossRef - Tumor-Associated Macrophages Derived TGF-β‒Induced Epithelial to Mesenchymal Transition in Colorectal Cancer Cells through Smad2,3-4/Snail Signaling Pathway
Jianhui Cai, Limin Xia, Jinlei Li, Shichang Ni, Huayu Song, Xiangbin Wu
Cancer Research and Treatment.2019; 51(1): 252. CrossRef
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