Currently, no established marker exists for predicting peritoneal metastasis progression during chemotherapy, although they are major interruptive factors in sequential chemotherapy in patients with advanced gastric cancer (AGC). This multicenter retrospective study was conducted from June 2015 to July 2019, analyzing 73 patients with AGC who underwent taxane-plus-ramucirumab (TAX/RAM) therapy and had their serum carbohydrate antigen 125 (CA125) concentrations measured. Of 31 patients with elevated CA125 levels above a cutoff of 35 U/mL, 25 (80.6%) had peritoneal metastasis. The CA125 concentrations before TAX/RAM treatment were associated with ascites burden. The overall survival was significantly shorter in the CA125-elevated group. CA125 kinetics, measured at a median of 28 days after chemotherapy, were associated with the ascites response (complete or partial response: −1.86%/day; stable disease: 0.28%/day; progressive disease: 2.33%/day). Progression-free survival in the CA125-increased group, defined by an increase of 0.0067%/day using receiver operating characteristic curve analysis, was significantly poorer among patients with peritoneal metastases. In conclusion, this study highlights that CA125 kinetics can serve as an early predictor for the progression of peritoneal metastasis during TAX/RAM treatment.
目前，尽管腹膜转移是晚期胃癌患者序贯化疗中的主要干扰因素，但尚无确切的标志物可用于预测化疗期间腹膜转移的进展。本研究为一项多中心回顾性研究，时间跨度为2015年6月至2019年7月，共纳入73例接受紫杉醇联合雷莫西尤单抗治疗并检测了血清糖类抗原125浓度的晚期胃癌患者进行分析。在31例CA125水平高于临界值35 U/mL的患者中，25例存在腹膜转移。TAX/RAM治疗前的CA125浓度与腹水负荷相关。CA125升高组的总生存期显著缩短。化疗后中位28天测得的CA125动力学变化与腹水反应相关。通过受试者工作特征曲线分析，将CA125每日增长率超过0.0067%定义为CA125升高组，该组腹膜转移患者的无进展生存期显著更差。总之，本研究强调CA125动力学变化可作为TAX/RAM治疗期间腹膜转移进展的早期预测指标。
肿瘤(癌症)患者之家