Assessing novel prognostic serum biomarkers in advanced pancreatic cancer: the role of CYFRA 21-1, serum amyloid A, haptoglobin, and 25-OH vitamin D3

作者:Haas Michael*; Kern Christoph; Kruger Stephan; Michl Marlies; Modest Dominik P; Giessen Clemens; Schulz Christoph; von Einem Jobst C; Ormanns Steffen; Laubender Ruediger P; Holdenrieder Stefan; Heinemann Volker; Boeck Stefan
来源:Tumor Biology, 2015, 36(4): 2631-2640.
DOI:10.1007/s13277-014-2885-x

摘要

The present prospective single-center study investigated the prognostic role of novel serum biomarkers in advanced pancreatic cancer (PC). Patients (pts) with locally advanced or metastatic PC treated with first-line palliative chemotherapy were included. Among others, the serum markers CYFRA 21-1, haptoglobin, serum-amyloid A (SAA), and 25-OH vitamin D3 were determined at baseline and categorized by pre-defined cut-offs [median values (MV), upper limits of normal (ULN), lower limits of normal (LLN), or the natural logarithm (ln)] and correlated with overall survival (OS). Among the 59 pts included, pre-treatment CYFRA 21-1 levels showed a strong correlation with OS independent of the applied cut-off (MV 4.9 ng/ml-14.2 vs. 4.2 months, HR 0.18, p=0.001; ULN 3.3 ng/ml-14.2 vs. 4.4 months, HR 0.28, p=0.003; [ln] CYFRA 21-1-HR 0.77, p=0.013). Lower values of haptoglobin were additionally associated with an improvement in OS (categorized by LLN of 2.05 g/l-10.4 vs. 5.5 months, HR 0.46, p=0.023; [ln] haptoglobin-HR 0.51, p=0.036). Pts with baseline SAA values below the MV of 22 mg/l also had a prolonged OS (10.4 vs. 5.0 months, HR 0.47, p=0.036). For 25-OH vitamin D3 levels, no significant correlation with OS was found. In multivariate analyses, pretreatment CYFRA 21-1 levels (categorized by MV-HR 0.15, p=0.032) as well as [ln] haptoglobin (HR 0.30, p=0.006) retained their independent prognostic significance for OS. CYFRA 21-1, haptoglobin, and SAA might provide useful prognostic information in advanced PC. An external multicenter validation of these results is necessary.