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dc.contributor.authorThomsen, Maria
dc.contributor.authorSkovlund, Eva
dc.contributor.authorSorbye, Halfdan
dc.contributor.authorBolstad, Nils
dc.contributor.authorNustad, Kjell Johannes
dc.contributor.authorGlimelius, Bengt
dc.contributor.authorPfeiffer, Per
dc.contributor.authorKure, Elin Wenche Hegland
dc.contributor.authorJohansen, Julia S.
dc.contributor.authorTveit, Magne Kjell
dc.contributor.authorChristoffersen, Thoralf
dc.contributor.authorGuren, Tormod Kyrre
dc.identifier.citationBritish Journal of Cancer. 2018, 118 (12), 1609-1616.nb_NO
dc.description.abstractBackground Mutation status of RAS and BRAF, as well as serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9), are biomarkers used in clinical management of patients with gastrointestinal cancers. This study aimed to examine the prognostic role of these biomarkers in a patient population that started first-line chemotherapy for unresectable metastatic colorectal cancer (mCRC) in the NORDIC-VII study. Methods CEA and CA 19-9 were measured in serum samples from 545 patients obtained before the start of chemotherapy. Four hundred and ninety-four patients had detectable levels of carbohydrate antigen 19-9 (CA 19-9). RAS (exons 2–4) and BRAF (V600E) mutation status were available from 440 patients. Overall survival (OS) was estimated in patient groups defined by serum CEA or CA 19-9 levels using cut-off values of 5 µg/L and 35 kU/L, respectively, in the total population and in subgroups according to RAS and BRAF mutation status. Results For both CEA and CA 19-9, elevated serum levels were associated with reduced OS in adjusted analyses which included RAS and BRAF mutation status, baseline World Health Organization performance status, and levels of alkaline phosphatase and C-reactive protein. The negative prognostic information provided by an elevated CA 19-9 level was particularly marked in patients with BRAF mutation (hazard ratio = 4.35, interaction P = 0.003, in an adjusted model for OS). Conclusions High baseline serum concentrations of CEA and CA 19-9 provide independent information of impaired prognosis in mCRC. In patients with BRAF-mutant tumours, elevated serum CA 19-9 may identify a subgroup with highly aggressive disease and could contribute to improving therapeutic decisions.nb_NO
dc.publisherSpringer Naturenb_NO
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titlePrognostic role of carcinoembryonic antigen and carbohydrate antigen 19-9 in metastatic colorectal cancer: a BRAF-mutant subset with high CA 19-9 level and poor outcomenb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.source.journalBritish Journal of Cancernb_NO
dc.description.localcodeThis is a published version of an article published in British Journal of Cancer. Locked until 6.6.2019 due to copyright restrictions. The final authenticated version is available online at:
cristin.unitnameInstitutt for samfunnsmedisin og sykepleie

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