ASCO 2006 Update of Recommendations for the Use of Tumor Markers in Gastrointestinal Cancer
- Study type
- Clinical guideline
- Study name
- ASCO GI Tumor Markers 2006
- Design
- Clinical practice guideline update based on a literature review (search of Medline and the Cochrane Collaboration Library focusing on systematic reviews and meta-analyses)
- Source
- JCO · 2006
In plain words
This guideline explains when "tumour marker" blood tests can help the doctor in bowel cancer and pancreatic cancer. In bowel cancer, the CEA test can be useful before surgery, in follow-up after surgery and in checking the response to treatment. In pancreatic cancer, the CA 19-9 test can help monitor the disease in patients receiving active treatment, but a rise must be confirmed with other tests. These tests should always be interpreted with your treating doctor.
Key points
Key guideline recommendations
In colorectal cancer, preoperative CEA is recommended if it would assist in staging and surgical planning.
Postoperative CEA levels should be measured every 3 months for at least 3 years in patients with stage II and III disease if the patient is a potential candidate for surgery or chemotherapy for metastatic disease.
CEA is the marker of choice for monitoring the response of metastatic disease to systemic therapy.
Data are insufficient to recommend the routine use of p53, ras, thymidine synthase, dihydropyrimidine dehydrogenase, thymidine phosphorylase, microsatellite instability, 18q loss of heterozygosity or DCC protein in the management of patients with colorectal cancer.
In pancreatic cancer, CA 19-9 can be measured every 1 to 3 months in patients with locally advanced or metastatic disease receiving active treatment. A rise on serial measurements suggests progressive disease, but confirmation with other studies should be sought.
Study population
Patients with gastrointestinal cancers; the recommendations of this update given in the abstract cover colorectal cancer and pancreatic cancer.
Endpoints
The aim of the guideline is to update the recommendations for the use of tumour marker tests in the prevention, screening, treatment and surveillance of gastrointestinal cancers.
Safety and side effects
This document is a clinical guideline on the use of tumour markers and the abstract reports no data on treatment adverse effects.
Clinical significance and place in guidelines
This guideline provides a framework for using CEA in colorectal cancer (preoperatively, in surveillance of stage II and III disease and in monitoring treatment of metastatic disease) and CA 19-9 in advanced or metastatic pancreatic cancer. It also states that evidence was insufficient at the time for routine use of several molecular markers (including p53, ras and microsatellite instability). This document dates from 2006; the current status of the recommendations and newer guideline versions should be checked.
Limitations
This guideline is based on data published from 1999 up to the 2006 update and therefore may not reflect newer evidence. The abstract does not report the level of evidence or grade of the recommendations. For several markers, data were insufficient to recommend routine use.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.