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Clinical Chemistry 45: 1695-1707, 1999;
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(Clinical Chemistry. 1999;45:1695-1707.)
© 1999 American Association for Clinical Chemistry, Inc.

Articles

Kinetics of Serum Tumor Marker Concentrations and Usefulness in Clinical Monitoring

Jean-Michel Bidart1, François Thuillier2,a, Christine Augereau3, Jacqueline Chalas4, Alain Daver5, Nelly Jacob6, Françoise Labrousse7 and Hélène Voitot8

1 Département de Biologie Clinique, Institut Gustave-Roussy, 94805 Villejuif, France.

2 Laboratoire de Biochimie, Centre Hospitalier de Meaux, 6/8 Rue Saint Fiacre, 77100 Meaux, France.

3 Laboratoire de Biochimie, Hôpital Boucicaut, 75015 Paris, France.

4 Laboratoire de Biochimie, Hôpital Antoine-Béclère, 92141 Clamart, France.

5 Laboratoire de Radioimmunologie, Centre Paul-Papin, 49033 Angers, France.

6 Laboratoire de Biochimie, Centre Hospitalier Pitié-Salpétrière, 75013 Paris, France.

7 Laboratoire de Biochimie, Hôpital Laennec, 75007 Paris, France.

8 Laboratoire de Biochimie, Hôpital Beaujon, 92110 Clichy, France.
a Author for correspondence. Fax 33-164353706; e-mail fthuillier{at}fc horus-medical.fr.

Only a few markers have been instrumental in the diagnosis of cancer. In contrast, tumor markers play a critical role in the monitoring of patients. The patient's clinical status and response to treatment can be evaluated rapidly using the tumor marker half-life (t1/2) and the tumor marker doubling time (DT). This report reviews the interest of determining these kinetic parameters for prostate-specific antigen, human chorionic gonadotropin, {alpha}-fetoprotein, carcinoembryonic antigen, cancer antigen (CA) 125, and CA 15-3. A rise in tumor markers (DT) is a yardstick with which benign diseases can be distinguished from metastatic disease, and the DT can be used to assess the efficacy of treatments. A decline in the tumor marker concentration (t1/2) is a predictor of possible residual disease if the timing of blood sampling is soon after therapy. The discrepancies in results obtained by different groups may be attributable to the multiplicity of immunoassays, the intrinsic characteristics of each marker (e.g., antigen specificity, molecular heterogeneity, and associated forms), individual factors (e.g., nonspecific increases and renal and hepatic diseases) and methods used to calculate kinetics (e.g., exponential models and timing of blood sampling). This kinetic approach could be of interest to optimize patient management.




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