TY - JOUR
T1 - The current role of blood-based biomarkers in surgical decision-making in patients with localised pancreatic cancer
T2 - A systematic review
AU - Diab, Hadi M H
AU - Smith, Henry G
AU - Jensen, Kristian K
AU - Jørgensen, Lars N
N1 - Copyright © 2021 Elsevier Ltd. All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - INTRODUCTION: The role of blood-based biomarkers in surgical decision-making in patients with localised pancreatic cancer remains unclear. This review aimed to report the utility of blood-based biomarkers focusing on prediction of response to neoadjuvant therapy, prediction of surgical resectability and early relapse after surgery.MATERIALS AND METHODS: MEDLINE/PubMed, Embase and Web of Science were searched till October 2019. Studies published between January 2000 and September 2019 with a minimum of 20 patients with pancreatic adenocarcinoma, reporting the utility of at least one blood-based biomarker in predicting response to neoadjuvant therapy and predicting surgical resectability or early relapse after surgery were included.RESULTS: A total of 2604 studies were identified, of which 24 comprising of 3367 patients and 12 blood-based biomarkers were included. All included studies were observational. Levels of carbohydrate antigen (CA)19-9 were reported in the majority of the studies. Levels of CA19-9 predicted the response to neoadjuvant therapy and early relapse in 10 studies. CA125 levels above 35 U/ml were predictive of surgical irresectability in two studies. However, marked variation in both timing of sampling and cut-off values was noted between studies.CONCLUSION: Despite some evidence of potential benefit, the utility of currently available blood-based biomarkers in aiding surgical decision-making in patients undergoing potentially curative treatment for pancreatic cancer is limited by methodological heterogeneity. Standardisation of future studies may allow a more comprehensive analysis of the biomarkers described in this review.
AB - INTRODUCTION: The role of blood-based biomarkers in surgical decision-making in patients with localised pancreatic cancer remains unclear. This review aimed to report the utility of blood-based biomarkers focusing on prediction of response to neoadjuvant therapy, prediction of surgical resectability and early relapse after surgery.MATERIALS AND METHODS: MEDLINE/PubMed, Embase and Web of Science were searched till October 2019. Studies published between January 2000 and September 2019 with a minimum of 20 patients with pancreatic adenocarcinoma, reporting the utility of at least one blood-based biomarker in predicting response to neoadjuvant therapy and predicting surgical resectability or early relapse after surgery were included.RESULTS: A total of 2604 studies were identified, of which 24 comprising of 3367 patients and 12 blood-based biomarkers were included. All included studies were observational. Levels of carbohydrate antigen (CA)19-9 were reported in the majority of the studies. Levels of CA19-9 predicted the response to neoadjuvant therapy and early relapse in 10 studies. CA125 levels above 35 U/ml were predictive of surgical irresectability in two studies. However, marked variation in both timing of sampling and cut-off values was noted between studies.CONCLUSION: Despite some evidence of potential benefit, the utility of currently available blood-based biomarkers in aiding surgical decision-making in patients undergoing potentially curative treatment for pancreatic cancer is limited by methodological heterogeneity. Standardisation of future studies may allow a more comprehensive analysis of the biomarkers described in this review.
KW - Biomarkers, Tumor/blood
KW - CA-125 Antigen/blood
KW - CA-19-9 Antigen/blood
KW - Decision Making
KW - Humans
KW - Neoadjuvant Therapy
KW - Neoplasm Recurrence, Local
KW - Pancreatic Neoplasms/blood
UR - http://www.scopus.com/inward/record.url?scp=85109141565&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2021.05.033
DO - 10.1016/j.ejca.2021.05.033
M3 - Journal article
C2 - 34243080
SN - 0959-8049
VL - 154
SP - 73
EP - 81
JO - European journal of cancer (Oxford, England : 1990)
JF - European journal of cancer (Oxford, England : 1990)
ER -