Published in:
01-04-2015 | Research Article
Assessing novel prognostic serum biomarkers in advanced pancreatic cancer: the role of CYFRA 21-1, serum amyloid A, haptoglobin, and 25-OH vitamin D3
Authors:
Michael Haas, Christoph Kern, Stephan Kruger, Marlies Michl, Dominik P. Modest, Clemens Giessen, Christoph Schulz, Jobst C. von Einem, Steffen Ormanns, Rüdiger P. Laubender, Stefan Holdenrieder, Volker Heinemann, Stefan Boeck
Published in:
Tumor Biology
|
Issue 4/2015
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Abstract
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, pre-treatment 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.