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Prospective Study o...
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Dam, GitteAarhus Univ Hosp, Dept Gastroenterol & Hepatol, Neuroendocrine Tumour Ctr Excellence, DK-8200 Aarhus N, Denmark.
(author)
Prospective Study of Chromogranin A as a Predictor of Progression in Patients with Pancreatic, Small-Intestinal, and Unknown Primary Neuroendocrine Tumors
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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2019-10-02
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S. Karger AG,2020
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-411465
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411465URI
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https://doi.org/10.1159/000503833DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Ulrich Knigge and Eva Tiensuu Janson shared last co-authorship.
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Background: Retrospective studies are conflicting but most of them report that an increase in plasma chromogranin A (CgA) predicts tumor progression in neuroendocrine tumor (NET) patients. Prospectively, we investigated if a change in plasma CgA is associated with tumor burden changes in NET patients with disseminated disease. Methods: We included 239 patients treated at 5 NET centers from December 2010 to December 2013. CgA was measured within 6 weeks of a CT or MRI in a patient undergoing at least 2 scan examinations performed over a period of 1-24 months. In a post hoc analysis, CgA measured 3-6 months prior to the CT/MRI was analyzed. Changes in tumor size were evaluated by RECIST1.1. A 25% change in CgA was chosen to discriminate between increased, decreased, or unchanged levels. Results: In 671 events (2 CT/MRI scans and 2 corresponding CgA measurements), we found a weak positive correlation between the RECIST 1.1 responses and change in plasma CgA from baseline (Spearman's rank correlation coefficient: 0.15; p < 0.05). Of 304 events in the post hoc analysis, 58 showed progression, 228 showed stable disease, and 18 showed regression, with a median change in CgA of 19% (IQR: 57 to -20%), -12% (23 to -38%), and -73% (-55 to -83%), respectively. The correlation coefficient for all sites was 0.17 (p = 0.003), and it was 0.16 (p = 0.07), 0.18 (p = 0.04), and 0.20 (p = 0.21) for small-intestinal (n = 137), pancreatic (n = 123), and unknown primary NET (n = 40), respectively. In the 58 patients showing tumor progression, the sensitivity and specificity of an increased CgA concentration were 36 and 82%, respectively, with positive and negative predictive values of 32 and 85%. Conclusions: In this prospective study of gastroenteropancreatic NET patients, we observed only a weak association between a change in plasma CgA and changes in tumor burden. CgA as a single biomarker was thus inadequate to predict tumor progression.
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Gronbaek, HenningAarhus Univ Hosp, Dept Gastroenterol & Hepatol, Neuroendocrine Tumour Ctr Excellence, DK-8200 Aarhus N, Denmark.
(author)
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Sorbye, HalfdanHaukeland Hosp, Dept Oncol, Bergen, Norway.;Univ Bergen, Clin Sci, Bergen, Norway.
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Evensen, Espen ThiisOslo Univ Hosp, Rigshosp, Dept Transplantat Med, Neuroendocrine Tumor Ctr Excellence, Oslo, Norway.
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Paulsson, BjornNovartis Sverige AB, Kista, Sweden.
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Sundin, Anders,1954-Uppsala universitet,Radiologi,Uppsala Univ Hosp, Neuroendocrine Tumor Ctr Excellence, Uppsala, Sweden.(Swepub:uu)anderssu
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Jensen, ClausRigshosp, Neuroendocrine Tumour Ctr Excellence, Dept Radiol, Copenhagen, Denmark.
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Ebbesen, DyvekeAarhus Univ Hosp, Neuroendocrine Tumour Ctr Excellence, Dept Radiol, Aarhus, Denmark.
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Knigge, UlrichRigshosp, Neuroendocrine Tumour Ctr Excellence, Dept Endocrinol, Copenhagen, Denmark.;Rigshosp, Neuroendocrine Tumour Ctr Excellence, Dept Surg Gastroenterol, Copenhagen, Denmark.
(author)
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Tiensuu Janson, EvaUppsala universitet,Onkologisk endokrinologi(Swepub:uu)evatieja
(author)
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Aarhus Univ Hosp, Dept Gastroenterol & Hepatol, Neuroendocrine Tumour Ctr Excellence, DK-8200 Aarhus N, Denmark.Haukeland Hosp, Dept Oncol, Bergen, Norway.;Univ Bergen, Clin Sci, Bergen, Norway.
(creator_code:org_t)
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In:Neuroendocrinology: S. Karger AG110:3/4, s. 217-2240028-38351423-0194
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