Tuğba AKIN TELLİ, Nalan AKGÜL BABACAN, Özkan ALAN, Mehmet Akif ÖZTÜRK, Rahib HASANOV, Sinan KOCA, Süleyman HALİL, Eda TANRIKULU ŞİMŞEK, Tuğba BAŞOĞLU, Özlem ERCELEP, Faysal DANE, Perran Fulden YUMUK

İleri Evre Gastrointestinal Kanserli Hastalarda Fibrin ile İlişkili Yeni Bir Biyobelirteç Olan Serum DR-70 Düzeyinin Prognostik ve Prediktif Değeri

Amaç: DR-70, kandaki fibrin yıkım ürünlerini tespit eden yeni geliştirilmiş bir testtir. Bu çalışmada ileri evre gastrointestinal (GI) kanserlerde DR- 70’in tedavi yanıtını izlemedeki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmaya farklı serilerdeki sistemik tedaviler ile tedavi edilen ileri evre GI kanserli hastalar dahil edildi. Görüntüleme çalışmaları, DR-70 ve geleneksel tümör belirteçleri [karsinoembriyonik antijen (CEA), karbonhidrat antijeni (CA) 19-9] başlangıçta ve tedavinin üçüncü ayında tekrarlandı. Bulgular: Çalışmaya kolorektal (%52,1), özofagogastrik (%32,4) ve pankreatikobiliyer kanser (%15,5) tanısı konan toplam 142 hasta alındı. Hastaların çoğu birinci basamak tedavi alıyordu (%56,3). Hastaların %57’sinde ikinci kan örneği alındı. Özofagogastrik kanseri olan hastalarda, DR-70 yanıtı tedavi yanıtı ile iyi korelasyon gösterdi (p=0,007) ve başlangıçta düşük serum DR-70 düzeyi, daha uzun genel sağkalım ile anlamlı şekilde ilişkiliydi (p=0,02). Kolorektal kanserli hastalarda tedavi öncesi DR-70 ile CEA düzeyleri arasında pozitif fakat zayıf bir korelasyon (p=0,03, r=0,244) varken, tedavi öncesi DR-70 ile CA 19-9 arasında özofagogastrik ve pankreatikobilier kanserlerde orta düzeyde pozitif bir korelasyon vardı (sırasıyla p=0,01, r=0,402 ve p=0,04, r=0,515). DR-70 konsantrasyonunda %25’ten fazla azalma, daha iyi genel ve progresyonsuz sağkalım ile ilişkiliydi. Sonuç: DR-70, özellikle özofagogastrik kanserde tedaviye yanıtı ve sağkalımı ön gören güçlü bir belirteçtir.

The Prognostic and Predictive Value of DR-70 Immunoassay, A Novel Fibrin-Associated Biomarker, in Patients with Advanced Gastrointestinal Cancers

Aim: DR-70 is a newly developed immunoassay that detects fibrin degradation products in blood. We aimed to evaluate ability of DR-70 in monitoring treatment response in advanced gastrointestinal (GI) cancers. Materials and Methods: We prospectively enrolled patients with advanced GI cancers treated with different lines of systemic therapies. Imaging studies, DR-70 and conventional tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9] were analyzed at baseline and on the third month of treatment. Results: A total of 142 patients diagnosed with colorectal (52.1%), esophago-gastric (32.4%) and pancreaticobiliary cancer (15.5%) were enrolled. Most patients were getting first-line treatment (56.3%). Second blood sampling was performed in 57% of patients. Among patients with esophagogastric cancer, DR-70 response correlated well with treatment response (p=0.007) and low baseline DR-70 level was significantly associated with longer overall survival (p=0.02). There was a positive but weak correlation between pre-treatment DR-70 and CEA levels (p=0.03, r=0.244) in patients with colorectal cancer, while a moderate positive correlation was present between pre-treatment DR-70 and CA 19-9 levels in esophagoAim: DR-70 is a newly developed immunoassay that detects fibrin degradation products in blood. We aimed to evaluate ability of DR-70 in monitoring treatment response in advanced gastrointestinal (GI) cancers. Materials and Methods: We prospectively enrolled patients with advanced GI cancers treated with different lines of systemic therapies. Imaging studies, DR-70 and conventional tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9] were analyzed at baseline and on the third month of treatment. Results: A total of 142 patients diagnosed with colorectal (52.1%), esophago-gastric (32.4%) and pancreaticobiliary cancer (15.5%) were enrolled. Most patients were getting first-line treatment (56.3%). Second blood sampling was performed in 57% of patients. Among patients with esophagogastric cancer, DR-70 response correlated well with treatment response (p=0.007) and low baseline DR-70 level was significantly associated with longer overall survival (p=0.02). There was a positive but weak correlation between pre-treatment DR-70 and CEA levels (p=0.03, r=0.244) in patients with colorectal cancer, while a moderate positive correlation was present between pre-treatment DR-70 and CA 19-9 levels in esophago-

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