Cancer Res Treat.  2016 Jan;48(1):153-161. 10.4143/crt.2014.183.

The Role of Plasma Chromogranin A as Assessment of Treatment Response in Non-functioning Gastroenteropancreatic Neuroendocrine Tumors

• Kim M
• Lee S
• Lee J
• Park SH
• Park JO
• Park YS
• Kang WK
• Kim ST

• KMID: 2152271
• DOI: http://doi.org/10.4143/crt.2014.183

Abstract

PURPOSE
Chromogranin A (CgA) has been considered to be valuable not only in the diagnosis but also in monitoring the disease response to treatment. However, only a few studies have been published on this issue. We purposed to evaluate whether biochemical response using plasma CgA level is reliable in concordance with the clinical response of grade 1-3 nonfunctiong gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
MATERIALS AND METHODS
Between March 2011 and September 2013, a total of 27 cases in 18 patients were analysed, clinically and radiologically while serial CgA tests were also conducted during treatment. Tumor responses were defined by both Response Evaluation Criteria in Solid Tumors (RECIST) criteria ver. 1.1 and biochemical criteria based on the CgA level.
RESULTS
Among the 27 cases analysed, no difference in the basal CgA level was observed with regard to gender, primary tumor site, tumor grade (World Health Organization classification), liver metastasis, number of metastatic site, and line of chemotherapy. The overall response rate (RR) by RECIST criteria ver. 1.1 was six out of the 27 cases (22.2%) and eight out of the 27 cases (29.6%) for biochemical RR. The overall concordance rates of the response based on RECIST and biochemical criteria were 74%. In grades 1 and 2 GEP-NETs (n=17), the concordance rate of the disease control was 94.1%. There was a significant difference for progression-free survival (PFS) between responders and non-responder in accordance to biochemical criteria (35.73 months vs. 5.93 months, p=0.05).
CONCLUSION
This study revealed that changes of the plasma CgA levels were associated with tumour response. Additionally, biochemical response based on serial CgA may be a predictive marker for PFS in GEP-NETs.

Keyword

Chromogranin A; Gastro-enteropancreatic neuroendocrine tumor; Predictive

MeSH Terms

Chromogranin A*
Diagnosis
Disease-Free Survival
Drug Therapy
Humans
Liver
Neoplasm Metastasis
Neuroendocrine Tumors*
Plasma*
Chromogranin A

Figure

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  Fig. 1. Association of treatment responses with percentage changes in the chromogranin A (CgA) levels compared to the baseline levels in grades 1-3 (A) and grades 1-2 (B) cases.

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  Fig. 2. Changes in the chromogranin A levels in patients who achieved the tumor response.

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  Fig. 3. Progression free survival (PFS) according to the status of the biochemical response.

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  Fig. 4. Subgroup analysis of progression-free survival (PFS) between responders and non-responders of chromogranin A according to Response Evaluation Criteria in Solid Tumors criteria (A), tumor grade (B), and primary sites (C). GEP-NETs, gastroenteropancreatic neuroendocrine tumors.

Reference

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