Relationship between CA199 and prognosis of patients with advanced pancreatic cancer

Objective To analyze the relationship between level of CA199 decrease after two cycles of chemotherapy and prognosis in patients with advanced pancreatic cancer. Methods Totally 110 patients with advanced pancreatic cancer treated in our hospital from 2010 to 2018 were enrolled into our study. There were 74 males and 36 females with age ranging from 30 to 79 years old.CA199 was measured at baseline and after two cycles of chemotherapy. According to the decrease of CA199 level(CA199 changed from baseline to 2 cycles after chemotherapy: decrease>0 vs decrease≤0; decrease≥20% vs decrease<20%; decrease≥40% vs decrease<40%) and different chemotherapy protocol, patients were divided into different groups. And then survival analysis was performed. Results After 2 cycles of chemotherapy, the mOS and mPFS of patients with CA199 decrease>0 was 10.4 months and 4.7 months, which was significantly longer than those of patients with decrease≤0(mOS, 5.8 months; mPFS, 3.1 months)(P<0.05, respectively), and they were also found to be longer in patients with CA199 decrease≥20% than patients with decrease<20%(mOS: 11.0 months vs 5.9 months, HR=0.004; mPFS: 5.0 months vs 3.1 months, HR=0.001). Compared to the patients with CA199 decrease<40%, patients with CA199 decrease ≥40% had better prognosis(mOS, 11.1 months vs 6.6 months, HR=0.014; mPFS,4.8 months vs 3.5 months, HR=0.042). Gemcitabine plus S1 and Gemcitabine plus nab-Paclitaxel had better efficacy than other chemotherapy regimens. And the more CA199 decrease, the better prognosis patients had. Conclusion CA199 decrease after 2 cycles of chemotherapy can be an early indicator for chemotherapy efficacy.