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Relevance of circulating nucleosomes and oncological biomarkers for predicting response to transarterial chemoembolization therapy in liver cancer patients.

Kohles N, Nagel D, Jüngst D, Durner J, Stieber P, Holdenrieder S - BMC Cancer (2011)

Bottom Line: Transarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients.The risk score of this combination model achieved an AUC of 81.8% in receiver operating characteristic (ROC) curves and a sensitivity for prediction of non-response to therapy of 41% at 97% specificity, and of 72% at 78% specificity.Circulating nucleosomes and liver markers are valuable tools for early estimation of the efficacy of TACE therapy in HCC patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Clinical Chemistry, University-Hospital Munich-Grosshadern, Germany.

ABSTRACT

Background: Transarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers predicting therapy response are urgently required.

Methods: Here, sera of 50 prospectively and consecutively included HCC patients undergoing 71 TACE therapies were taken before and 3 h, 6 h and 24 h after TACE application to analyze concentrations of circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), C-reactive protein (CRP) and several liver biomarkers, and to compare these with radiological response to therapy.

Results: While nucleosomes, CYFRA 21-1, CRP and some liver biomarkers increased already 24 h after TACE, percental changes of nucleosome concentrations before and 24 h after TACE and pre- and posttherapeutic values of AFP, gamma-glutamyl-transferase (GGT) and alkaline phosphatase (AP) significantly indicated the later therapy response (39 progression versus 32 no progression). In multivariate analysis, nucleosomes (24 h), AP (24 h) and TACE number were independent predictive markers. The risk score of this combination model achieved an AUC of 81.8% in receiver operating characteristic (ROC) curves and a sensitivity for prediction of non-response to therapy of 41% at 97% specificity, and of 72% at 78% specificity.

Conclusion: Circulating nucleosomes and liver markers are valuable tools for early estimation of the efficacy of TACE therapy in HCC patients.

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Related in: MedlinePlus

Box-plots of serum levels of nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), and C-reactive protein (CRP) showing medians, interquartile ranges, minimum and maximum in all patients during the first day after TACE (★ indicate significant changes from 0 h values).
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Figure 1: Box-plots of serum levels of nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), and C-reactive protein (CRP) showing medians, interquartile ranges, minimum and maximum in all patients during the first day after TACE (★ indicate significant changes from 0 h values).

Mentions: As early as 24 h after application of TACE, concentrations of circulating nucleosomes, CYFRA 21-1, LDH, CRP, bilirubin, and activity of liver enzymes were increased in most patients. In contrast, median activities of pancreas enzymes lipase, amylase and alkaline phosphatase (AP), and choline esterase, as well as concentration of AFP were decreased or stable when compared to pretherapeutic values (Table 2 and Figure 1).


Relevance of circulating nucleosomes and oncological biomarkers for predicting response to transarterial chemoembolization therapy in liver cancer patients.

Kohles N, Nagel D, Jüngst D, Durner J, Stieber P, Holdenrieder S - BMC Cancer (2011)

Box-plots of serum levels of nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), and C-reactive protein (CRP) showing medians, interquartile ranges, minimum and maximum in all patients during the first day after TACE (★ indicate significant changes from 0 h values).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3118895&req=5

Figure 1: Box-plots of serum levels of nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), and C-reactive protein (CRP) showing medians, interquartile ranges, minimum and maximum in all patients during the first day after TACE (★ indicate significant changes from 0 h values).
Mentions: As early as 24 h after application of TACE, concentrations of circulating nucleosomes, CYFRA 21-1, LDH, CRP, bilirubin, and activity of liver enzymes were increased in most patients. In contrast, median activities of pancreas enzymes lipase, amylase and alkaline phosphatase (AP), and choline esterase, as well as concentration of AFP were decreased or stable when compared to pretherapeutic values (Table 2 and Figure 1).

Bottom Line: Transarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients.The risk score of this combination model achieved an AUC of 81.8% in receiver operating characteristic (ROC) curves and a sensitivity for prediction of non-response to therapy of 41% at 97% specificity, and of 72% at 78% specificity.Circulating nucleosomes and liver markers are valuable tools for early estimation of the efficacy of TACE therapy in HCC patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Clinical Chemistry, University-Hospital Munich-Grosshadern, Germany.

ABSTRACT

Background: Transarterial chemoembolization (TACE) therapy is an effective locoregional treatment in hepatocellular cancer (HCC) patients. For early modification of therapy, markers predicting therapy response are urgently required.

Methods: Here, sera of 50 prospectively and consecutively included HCC patients undergoing 71 TACE therapies were taken before and 3 h, 6 h and 24 h after TACE application to analyze concentrations of circulating nucleosomes, cytokeratin-19 fragments (CYFRA 21-1), alpha fetoprotein (AFP), C-reactive protein (CRP) and several liver biomarkers, and to compare these with radiological response to therapy.

Results: While nucleosomes, CYFRA 21-1, CRP and some liver biomarkers increased already 24 h after TACE, percental changes of nucleosome concentrations before and 24 h after TACE and pre- and posttherapeutic values of AFP, gamma-glutamyl-transferase (GGT) and alkaline phosphatase (AP) significantly indicated the later therapy response (39 progression versus 32 no progression). In multivariate analysis, nucleosomes (24 h), AP (24 h) and TACE number were independent predictive markers. The risk score of this combination model achieved an AUC of 81.8% in receiver operating characteristic (ROC) curves and a sensitivity for prediction of non-response to therapy of 41% at 97% specificity, and of 72% at 78% specificity.

Conclusion: Circulating nucleosomes and liver markers are valuable tools for early estimation of the efficacy of TACE therapy in HCC patients.

Show MeSH
Related in: MedlinePlus