J Cancer 2017; 8(8):1410-1416. doi:10.7150/jca.18325

Research Paper

The Prognostic and Predictive Value of Carbohydrate Antigen 19-9 in Metastatic Colorectal Cancer Patients with First Line Bevacizumab Containing Chemotherapy

Chang Jiang1, 2, 3*, Shousheng Liu1, 2, 3*, Wenzhuo He1, 2, 3, Bei Zhang1, 2, 3✉, Liangping Xia1, 2, 3✉

1. VIP Region, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, R.P. China;
2. State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, R.P. China;
3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, R.P. China.
* contributed equally to this paper

Abstract

Objective: We had previously demonstrated that the carbohydrate antigen 19-9 (CA19-9), lactate dehydrogenase (LDH), neutrophil lymphocyte ratio (NLR) are prognostic factors for patients with metastatic colorectal cancer (mCRC). In this study, we try to analysis the association of these blood-based biomarkers with bevacizumab efficacy in the first line setting.

Methods: A total of 284 eligible consecutive mCRC patients who received first-line chemotherapy with or without bevacizumab were studied from 2007 to 2014 at Sun Yat-Sen University Cancer Center. The endpoints were overall survival (OS), progression free survival (PFS).

Results: Among all the patients, the initial elevated CA19-9, high LDH, and NLR > 2.47 were confirmed as independent unfavorable prognostic factors. The CA19-9 and LDH levels were significantly associated with PFS. In the high CA19-9 subgroup, patients had favorable OS from bevacizumab administration in the first line therapy (32.1 vs. 20.1 months, P = 0.03), but without PFS benefit. In terms of different levels of LDH, and NLR, there were no survival benefit from bevacizumab treatment.

Conclusions: Our results suggest that the initial CA19-9, LDH, and NLR levels could be independent prognostic biomarkers in mCRC patients. And among all these factors, the initial high CA19-9 level could be a predictor for bevacizumab effect.

Keywords: carbohydrate antigen 19-9, bevacizumab, predictive marker, overall survival, metastatic colorectal cancer.

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How to cite this article:
Jiang C, Liu S, He W, Zhang B, Xia L. The Prognostic and Predictive Value of Carbohydrate Antigen 19-9 in Metastatic Colorectal Cancer Patients with First Line Bevacizumab Containing Chemotherapy. J Cancer 2017; 8(8):1410-1416. doi:10.7150/jca.18325. Available from http://www.jcancer.org/v08p1410.htm