Abstract
Background
To examine the relationship between carcinoembryonic antigen (CEA) kinetics and prognosis
in metastatic colorectal cancer (mCRC) patients receiving first-line chemotherapy
in the PRODIGE9 trial.
Methods
Associations between monthly CEA measurements within 6 months since baseline and progression-free
survival (PFS) were evaluated using a joint-latent class-mixed model. A validation
set was used to test our prognosis model. Correlations between CEA trajectories (classes)
and baseline characteristics were also investigated.
Results
Three classes were identified. Class 1 had low baseline CEA with small variations.
Class 2 had high baseline CEA with a rapid decrease reaching the same CEA level at
6 months as in class 1. Class 3 had high baseline CEA with a transient decrease followed
by an increase to reach, at 6 months, the same CEA level as at baseline. Six-month
PFS was significantly lower in class 3 than in classes 1 and 2 (57% vs. 91% and 93%
respectively; p<0.01). Class 3 was significantly associated with ECOG 2 status, a high LDH level
and non-resected primary tumor.
Discussion
Variations in CEA kinetics correlate with prognosis in patients receiving first-line
chemotherapy for mCRC. We propose here a user-friendly application to classify CEA
trajectory.
Keywords
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Article info
Publication history
Published online: January 30, 2023
Accepted:
December 26,
2022
Received:
September 15,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
