{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:16:04Z","timestamp":1788934564580,"version":"build-2803163510"},"reference-count":41,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n            <jats:title>PURPOSE<\/jats:title>\n            <jats:p>Dynamics of carbohydrate antigen 19-9 (CA19-9) often inform treatment decisions during and after neoadjuvant chemotherapy (NAT) of patients with pancreatic ductal adenocarcinoma (PDAC). However, considerable dispute persists regarding the clinical relevance of specific CA19-9 thresholds and dynamics. Therefore, we aimed to define optimal thresholds for CA19-9 values and create a biochemically driven composite score to predict survival in CA19-9-producing patients with PDAC after NAT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>Patients with PDAC who underwent NAT and surgical resection from 2012 to 2022 were retrospectively identified from three high-volume centers. CA19-9 nonproducers and patients with 90-day mortality, and macroscopically incomplete resections were excluded. A composite score was created on the basis of relative CA19-9 change and newly defined optimal thresholds of pre- and postneoadjuvant values for overall survival (OS) using patients from two centers and validated using data from the third center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>\n              A total of 492 patients met inclusion criteria in the development cohort. Optimal CA19-9 cutoff values for predicting a difference in OS were 202 U\/mL for preneoadjuvant and 78 U\/mL for postneoadjuvant levels. Furthermore, increase in CA19-9 during neoadjuvant treatment was associated with worse OS (median-OS, 17.5 months\n              <jats:italic>v<\/jats:italic>\n              26.0 months;\n              <jats:italic>P<\/jats:italic>\n              = .008). Not surpassing any or only one of these thresholds (composite score of 0-1) was associated with improved OS compared with patients with 2-3 points (median-OS, 29.9 months\n              <jats:italic>v<\/jats:italic>\n              15.8 months;\n              <jats:italic>P<\/jats:italic>\n              &lt; .001). Major serological response (90% decrease of CA19-9) had a positive and negative predictive value of 32% and 88%, respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>The composite score consisting of CA19-9 levels at diagnosis, after neoadjuvant treatment, and its dynamics demonstrates prognostic discrimination between low and high scores. However, better predictive biomarkers are needed to facilitate treatment decisions during neoadjuvant treatment.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1200\/po.24.00193","type":"journal-article","created":{"date-parts":[[2024,11,20]],"date-time":"2024-11-20T20:59:19Z","timestamp":1732136359000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":5,"title":["Development of a Composite Score Based on Carbohydrate Antigen 19-9 Dynamics to Predict Survival in Carbohydrate Antigen 19-9\u2013Producing Patients With Pancreatic Ductal Adenocarcinoma After Neoadjuvant Treatment"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0257-1654","authenticated-orcid":true,"given":"Ingmar F.","family":"Rompen","sequence":"first","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"},{"name":"Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Sereni","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"},{"name":"Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3445-2278","authenticated-orcid":true,"given":"Joseph R.","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"},{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5481-2926","authenticated-orcid":true,"given":"Jonathan","family":"Garnier","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"},{"name":"Department of Surgical Oncology, Aix-Marseille University, CRCM, Institut Paoli-Calmettes, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5781-1483","authenticated-orcid":true,"given":"Veronica","family":"Galimberti","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6582-3003","authenticated-orcid":true,"given":"Lucas R.","family":"Perez Rivera","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3069-0551","authenticated-orcid":true,"given":"Deepa","family":"Vatti","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-7269","authenticated-orcid":true,"given":"Kelly J.","family":"Lafaro","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Brock","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1205-6477","authenticated-orcid":true,"given":"Greg D.","family":"Sacks","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Burns","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Burkhart","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Turrini","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Aix-Marseille University, CRCM, Institut Paoli-Calmettes, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher L.","family":"Wolfgang","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9149-2247","authenticated-orcid":true,"given":"Jin","family":"He","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5463-5250","authenticated-orcid":true,"given":"Ammar A.","family":"Javed","sequence":"additional","affiliation":[{"name":"Department of Surgery, The NYU Grossman School of Medicine and NYU Langone Health, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2011.11.025"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2014.02.001"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.21037\/jgo-20-426"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.12931"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16030489"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.3337"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004915"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000006142"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.1049"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-15070-w"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003859"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.0017"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001850"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-023-00746-1"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02274"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.07.007"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2018.01.001"},{"key":"e_1_3_6_19_2","first-page":"832","article-title":"Minimum and optimal CA19-9 response after two months induction chemotherapy in patients with locally advanced pancreatic cancer: A nationwide multicenter study","volume":"279","author":"Seelen LWF","year":"2024","unstructured":"Seelen LWF, Doppenberg D, Stoop TF, et al: Minimum and optimal CA19-9 response after two months induction chemotherapy in patients with locally advanced pancreatic cancer: A nationwide multicenter study. 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