{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:18:49Z","timestamp":1784557129943,"version":"3.55.0"},"reference-count":7,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["etj.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Serum calcitonin (CT) and carcinoembryonic antigen (CEA) are valuable tumour markers in patients with medullary thyroid carcinoma (MTC). Both markers most often evolve in parallel after treatment. Selpercatinib (LOXO-292) is a highly selective\n                      <jats:italic>RET<\/jats:italic>\n                      kinase inhibitor indicated in advanced\n                      <jats:italic>RET<\/jats:italic>\n                      -mutant MTC patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases presentation<\/jats:title>\n                    <jats:p>\n                      In this study, we report two observations of\n                      <jats:italic>RET<\/jats:italic>\n                      -mutant progressive metastatic and symptomatic MTC patients who were treated with selpercatinib. Patient 1, a 61-year-old man, presented dyspnoea and diarrhoea at selpercatinib initiation with large neck lymph nodes and lung metastases. Patient 2, a 76-year-old man, had acute discomfort with flush and diarrhoea, with small but diffuse bone and liver disease. Both patients had an objective tumour response with rapid clinical improvement and RECIST 1.1 response (\u221290%) in patient 1. A rapid dramatic decrease in CT level was observed in both patients (\u221299% in both patients), while CEA levels gradually and sustainably increased after selpercatinib initiation (+207% at cycle 15 in patient 1 and\u2009+\u2009835% at cycle 14 in patient 2). In both patients,\n                      <jats:sup>18<\/jats:sup>\n                      FDG PET\/CT did not show any abnormal uptake that could explain the CEA increase. Colonoscopy and oesogastric fibroscopy showed colonic polyposis with mild oesophagitis and gastritis in patient 1 and were normal in patient 2.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These observations show an unusual and lasting increase in serum CEA in two MTC patients who exhibited an objective tumour response to selpercatinib. The mechanism behind this unexpected rise in CEA level remains unknown. The frequency of this evolving profile will be determined in further phase III studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-21-0104","type":"journal-article","created":{"date-parts":[[2022,1,10]],"date-time":"2022-01-10T12:05:07Z","timestamp":1641816307000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":4,"title":["Unusual increase in carcinoembryonic antigen despite response to selpercatinib in two patients with medullary thyroid cancer"],"prefix":"10.1530","volume":"11","author":[{"given":"St\u00e9phane","family":"Bardet","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine and Thyroid Unit, Centre Fran\u00e7ois Baclesse, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Ciappuccini","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Thyroid Unit, Centre Fran\u00e7ois Baclesse, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Lamartina","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Leboulleux","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Thyroid","first-page":"567","article-title":"Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma","volume":"25","author":"Wells","year":"2015","unstructured":"Wells Jr SAAsa SLDralle HElisei REvans DBGagel RFLee NMachens AMoley JFPacini Fet al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid201525567\u2013610. (https:\/\/doi.org\/10.1089\/thy.2014.0335)"},{"key":"bib2","series-title":"European Journal of Endocrinology","first-page":"239","article-title":"Progression of medullary thyroid carcinoma: assessment with calcitonin and carcinoembryonic antigen doubling times","volume":"158","author":"Giraudet","year":"2008","unstructured":"Giraudet ALAl Ghulzan AAuperin ALeboulleux SChehboun ATroalen FDromain CLumbroso JBaudin ESchlumberger M. Progression of medullary thyroid carcinoma: assessment with calcitonin and carcinoembryonic antigen doubling times. European Journal of Endocrinology2008158239\u2013246. (https:\/\/doi.org\/10.1530\/EJE-07-0667)"},{"key":"bib3","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"6077","article-title":"Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling-times in patients with medullary thyroid carcinoma","volume":"90","author":"Barbet","year":"2005","unstructured":"Barbet JCampion LKraeber-Bodere FChatal JF & GTE Study Group. Prognostic impact of serum calcitonin and carcinoembryonic antigen doubling-times in patients with medullary thyroid carcinoma. Journal of Clinical Endocrinology and Metabolism2005906077\u20136084. (https:\/\/doi.org\/10.1210\/jc.2005-0044)"},{"key":"bib4","series-title":"Cancer","first-page":"657","article-title":"Relationship of tissue carcinoembryonic antigen and calcitonin to tumor virulence in medullary thyroid carcinoma. An immunohistochemical study in early, localized, and virulent disseminated stages of disease","volume":"54","author":"Mendelsohn","year":"1984","unstructured":"Mendelsohn GWells Jr SABaylin SB. Relationship of tissue carcinoembryonic antigen and calcitonin to tumor virulence in medullary thyroid carcinoma. An immunohistochemical study in early, localized, and virulent disseminated stages of disease. Cancer198454657\u2013662. (https:\/\/doi.org\/10.1002\/1097-0142(1984)54:4<657::aid-cncr2820540412>3.0.co;2-v)"},{"key":"bib5","series-title":"New England Journal of Medicine","first-page":"825","article-title":"Efficacy of selpercatinib in RET-altered thyroid cancers","volume":"383","author":"Wirth","year":"2020","unstructured":"Wirth LJSherman ERobinson BSolomon BKang HLorch JWorden FBrose MPatel JLeboulleux Set al. Efficacy of selpercatinib in RET-altered thyroid cancers. New England Journal of Medicine2020383825\u2013835. (https:\/\/doi.org\/10.1056\/NEJMoa2005651)"},{"key":"bib6","series-title":"Journal of Clinical Oncology","first-page":"4466","article-title":"Carcinoembryonic antigen surge in metastatic colorectal cancer patients responding to oxaliplatin combination chemotherapy: implications for tumor marker monitoring and guidelines","volume":"21","author":"Sorbye","year":"2003","unstructured":"Sorbye HDahl O. Carcinoembryonic antigen surge in metastatic colorectal cancer patients responding to oxaliplatin combination chemotherapy: implications for tumor marker monitoring and guidelines. Journal of Clinical Oncology2003214466\u20134467. (https:\/\/doi.org\/10.1200\/JCO.2003.99.200)"},{"key":"bib7","series-title":"Oncology","first-page":"49","article-title":"Chemotherapy-induced carcinoembryonic antigen surge in patients with metastatic colorectal cancer","volume":"70","author":"Ailawadhi","year":"2006","unstructured":"Ailawadhi SSunga ARajput AYang GYSmith JFakih M. 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(https:\/\/doi.org\/10.1159\/000091184)"}],"container-title":["European Thyroid Journal"],"original-title":[],"link":[{"URL":"https:\/\/etj.bioscientifica.com\/view\/journals\/etj\/11\/2\/ETJ-21-0104.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/etj.bioscientifica.com\/downloadpdf\/journals\/etj\/11\/2\/ETJ-21-0104.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/etj.bioscientifica.com\/downloadpdf\/journals\/etj\/11\/2\/ETJ-21-0104.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:51:31Z","timestamp":1784555491000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/etj\/article\/2830"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,1]]},"references-count":7,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/etj-21-0104","relation":{},"ISSN":["2235-0802"],"issn-type":[{"value":"2235-0802","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,1]]}}}