Carcinoembryonic Antigen Reduction After Medical Treatment in Patients with Metastatic Colorectal Cancer: a Systematic Review and Meta-analysis

Overview

Journal Int J Colorectal Dis

Specialties Gastroenterology
General Surgery

Date 2019 Jan 24

PMID 30671635

Citations 5

Authors

Giuseppe Antonio Colloca

Antonella Venturino

Domenico Guarneri

Affiliations

Soon will be listed here.

Abstract

Purpose: The introduction of new drugs and multimodal treatments for the management of patients with metastatic colorectal cancer (mCRC) has reduced the importance of time-to-event endpoints and reported the attention on the response-related endpoints. Furthermore, the prognostic role of the surgical scores before the resection of metastases has not been confirmed for multimodal treatments. The purpose of this research is to perform a meta-analysis of the studies that evaluated the relationship between carcinoembryonic antigen (CEA) response and outcome in patients with mCRC receiving systemic chemotherapy.

Methods: A systematic review of the literature on two databases and a selection of studies that evaluated the relationship between CEA response and outcome were performed according to predefined criteria. After, three meta-analyses were carried out on the selected studies, each for each outcome variable.

Results: Nineteen studies have been selected. Fourteen studies (1475 patients) have documented a close association between radiological response and CEA response (odds ratio (OR), 9.03; confidence intervals (CIs), 5.14-15.87; I statistic (I), 72%). Four studies have reported a longer progression-free survival for patients with a CEA response (hazard ratio (HR), 0.73; CIs, 0.64-0.83; I, 23%). Finally, 10 studies (13 study cohorts) have shown a strong relationship between CEA response and overall survival (OS) (HR, 0. 62; CIs, 0.55-0.70; I, 35%).

Conclusions: CEA response merits further investigation as a surrogate endpoint of clinical trials of first-line medical therapy of patients with mCRC, and should be studied as a prognostic factor for those patients who are candidates for multimodal treatment strategies.

Citing Articles

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

Lehtomaki K, Heerva E, Kellokumpu-Lehtinen P, Mustonen H, Salminen T, Joensuu H Int J Mol Sci. 2023; 24(7).

PMID: 37047727 PMC: 10094778. DOI: 10.3390/ijms24076753.

Dynamic monitoring of carcinoembryonic antigen, CA19-9 and inflammation-based indices in patients with advanced colorectal cancer undergoing chemotherapy.

Manojlovic N, Savic G, Nikolic B, Rancic N World J Clin Cases. 2022; 10(3):899-918.

PMID: 35127905 PMC: 8790463. DOI: 10.12998/wjcc.v10.i3.899.

Lead Time and Prognostic Role of Serum CEA, CA19-9, IL-6, CRP, and YKL-40 after Adjuvant Chemotherapy in Colorectal Cancer.

Lehtomaki K, Mustonen H, Kellokumpu-Lehtinen P, Joensuu H, Hermunen K, Soveri L Cancers (Basel). 2021; 13(15).

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Prognostic Impact of Pretreatment Elevated and Normalized Carcinoembryonic Antigen Levels After Neoadjuvant Chemoradiotherapy in Resected Locally Advanced Rectal Cancer Patients.

Song J, Chen Z, Huang D, Xu B Cancer Manag Res. 2021; 13:3713-3721.

PMID: 33994811 PMC: 8112854. DOI: 10.2147/CMAR.S299364.

A Review of Colorectal Cancer in Terms of Epidemiology, Risk Factors, Development, Symptoms and Diagnosis.

Sawicki T, Ruszkowska M, Danielewicz A, Niedzwiedzka E, Arlukowicz T, Przybylowicz K Cancers (Basel). 2021; 13(9).

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