oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2019-18-5-18-28oncotomsk-1184Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESПИЛОТНОЕ КЛИНИЧЕСКОЕ ИССЛЕДОВАНИЕ ПО МОНИТОРИНГУ ЭФФЕКТИВНОСТИ ХИМИОТЕРАПИИ ЗЛОКАЧЕСТВЕННЫХ ОПУХОЛЕЙ У ПАЦИЕНТОВ С ПОМОЩЬЮ МАРКЕРА ЭПИТЕЛИАЛЬНЫХ КАРЦИНОМ СА-62A PILOT CLINICAL TRIAL TO MONITOR RESPONSE TO CHEMOTHERAPY USING THE CA-62 MARKER OF EPITHELIAL CARCINOMAShttps://orcid.org/0000-0002-4970-5429ХакимоваГ. Г.KhakimovaG. G.

Хакимова Гульноз Голибовна, аспирант отделения химиотерапии и комбинированного лечения злокачественных опухолей

г. Москва, 115478, Каширское шоссе, 23

SPIN-код: 6939-8668

Gulnoz G. Khakimova, Postgraduate, Chemotherapy Department

23, Kashirskoye Shosse, Moscow, 115478

hgg_doc@mail.ruhttps://orcid.org/0000-0002-9074-7233ЧеркасоваЖ. Р.CherkasovaZh. R.

Черкасова Жаннета Рашидовна, кандидат химических наук, ведущий научный сотрудник, заведующая лабораторией онкомаркеров и новых методов диагностики опухолей

г. Москва, 143026, Б. Бульвар, 42/12 

SPIN-код: 4166-2280

Author ID (Scopus): 51162065700

Zhanetta R. Cherkasova, PhD, Leading Researcher, Head of the Laboratory of Cancer Markers and New Diagnostic Methods

42/1, B. Bulvar, Moscow 143026

Author ID (Scopus): 51162065700.

https://orcid.org/0000-0002-0030-1802ЦурканС. А.TsurkanS. A.

Цуркан Сергей Александрович, кандидат фармацевтических наук, ведущий научный сотрудник лаборатории онкомаркеров и новых методов диагностики опухолей

г. Москва, 143026, Б. Бульвар, 42/12 

SPIN-код: 5645-2279

Author ID (РИНЦ): 947434

Sergey A. Tsurkan, PhD, Leading Researcher, Head of the Laboratory of Cancer Markers and New Diagnostic Methods

42/1, B. Bulvar, Moscow 143026

ФедчиковГ. А.FedchikovG. A.

Федчиков Глеб Александрович, инженер-исследователь лаборатории онкомаркеров и новых методов диагностики опухолей

г. Москва, 143026, Б. Бульвар, 42/12 

Gleb A. Fedchikov, Research engineer, Laboratory of Cancer Markers and New Diagnostic Methods

42/1, B. Bulvar, Moscow 143026

СугановН. В.SuganovN. V.

Суганов Николай Валерьевич, хирург, врач-исследователь лаборатории онкомаркеров и новых методов диагностики опухолей

г. Москва, 143026, Б. Бульвар, 42/12 

Nikolay V. Suganov, MD, Surgeon, Laboratory of Cancer Markers and New Diagnostic Methods

42/1, B. Bulvar, Moscow 143026

https://orcid.org/0000-0003-0703-2550ГорбуноваВ. А.GorbunovaV. A.

Горбунова Вера Андреевна, доктор медицинских наук, профессор, ведущий научный сотрудник отделения химиотерапии и комбинированного лечения злокачественных опухолей

г. Москва, 115478, Каширское шоссе, 23

Author ID (РИНЦ): 140309

Vera A. Gorbunova, MD, DSc, Professor, Leading Researcher, Chemotherapy Department

23, Kashirskoye Shosse, Moscow, 115478

ФГБУ «НМИЦ онкологии имени Н.Н. Блохина» Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of OncologyRussian FederationООО «Джейвис Диагностикс» - Инновационный центр СколковоРоссияJavis Diagnostics LLC, Skolkovo Innovation CenterRussian Federation2019301020191851828Copyright © Хакимова Г.Г., Черкасова Ж.Р., Цуркан С.А., Федчиков Г.А., Суганов Н.В., Горбунова В.А., 20192019Хакимова Г.Г., Черкасова Ж.Р., Цуркан С.А., Федчиков Г.А., Суганов Н.В., Горбунова В.А.Khakimova G.G., Cherkasova Z.R., Tsurkan S.A., Fedchikov G.A., Suganov N.V., Gorbunova V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/1184

Цель исследования – оценка возможности использования контроля динамики сывороточного инновационного маркера эпителиальных карцином СА-62 для мониторинга лечения, выявления прогрессирования или стабилизации опухолевого процесса, а также для выявления рецидивов у пациентов в процессе химиотерапии.

Материал и методы

Материал и методы. Исследование проводилось в течение 12 мес двумя независимыми группами – клиническими онкологами и биохимиками в «двойном ослепленном» режиме. В пилотное клиническое исследование были включены 89 пациентов, имеющих различные солидные опухоли (рак желудка, мелкоклеточный рак легкого, колоректальный рак, нейроэндокринные опухоли и др.), подтвержденные результатами морфологического исследования, с наличием хотя бы одного измеряемого очага по критериям RECIST , состоянием на момент включения по ECOG 0–2 и удовлетворительными лабораторными показателями. Экспрессия онкомаркера СА-62 определялась при помощи опытного образца иммунохемилюминесцентного анализа «ИХА-СА-62», разработанного для выявления онкологических заболеваний эпителиального генеза, методом импульсной хемилюминесценции.

Результаты

Результаты. До лечения повышенный уровень биомаркера СА62 наблюдался у 76 % пациентов, который после химиотерапии снизился до нормальных референтных значений (<4600 Ед/мл) у 53 % больных, у 23 % пациентов он оставался повышенным. Из 24 % пациентов с изначально низким уровнем биомаркера (1000–4000 Ед/мл) у 12 % не наблюдалось изменений экспрессии СА-62 в ходе химиотерапии. После начала лечения у 5 % этой группы наблюдалось прогрессирование заболевания, у 7 % пациентов была достигнута стабилизация. У 12 % пациентов с изначально низким уровнем СА-62 наблюдался рост уровня онкомаркера в ходе лечения, что соответствовало прогрессированию заболевания.

Заключение

Заключение. Динамика изменений маркера СА-62 в ходе химиотерапии у больных раком желудка, мелкоклеточным раком, колоректальным раком, нейроэндокринными опухолями и раком яичников показала хорошую корреляцию (76–100 % в зависимости от локализации опухоли) с общим состоянием пациентов, согласно критериям RECIST . Показана возможность использования инновационного маркера эпителиальных карцином СА-62 для мониторинга, а также оценки проводимого системного лечения.

The objective of the study was to assess the feasibility of using CA -62 marker of epithelial carcinomas for monitoring treatment response and detecting cancer progression or recurrence during chemotherapy.

Material and Methods

Material and Methods. A 12-month double-blind clinical trial was conducted by two independent groups: clinical oncologists and biochemists, and involved 89 patients with different cancers confirmed by histopathological findings. The other inclusion criteria were: the presence of at least one measurable lesion according to the RECIST criteria, ECOG performance status 0-2 and satisfactory laboratory parameters. The expression of CA -62 cancer marker was measured by immunochemiluminescent assay used for the detection of epithelial carcinomas.

Results

Results. The elevated level of CA -62 marker was observed in 76 patients before starting the treatment. After completion chemotherapy, the level of this marker decreased to the normal reference ranges (<4600 U/ml) in 53 % of patients and remained increased in 24 % of patients. Of 24 % of patients with the initial low level of CA -62 marker (1000–4000 U/ml) before treatment, 12 % had no changes in the level of this marker during chemotherapy; however, 5 % of these patients had disease progression and 7 % had stable disease after starting the treatment. In 12 % of patients with an initial low CA -62 level, it increased during chemotherapy, indicating disease progression.

Conclusion

Conclusion. The changes in the level of CA -62 marker during chemotherapy in patients with gastric cancer, small-cell lung cancer, colorectal cancer, neuroendocrine cancer and ovarian cancer showed a high correlation (76–100 % depending on the tumor site) with the performance status of the patients according to RECIST criteria. The CA -62 marker was shown to be feasible for monitoring gastric cancer, small-cell lung cancer, colorectal cancer, neuroendocrine cancer and ovarian cancer as well as for assessing the response to chemotherapy.

химиотерапиярак желудкамелкоклеточный рак легкогоколоректальный ракрак яичниковнейроэндокринные опухолираковый антиген СА-62иммунохемилюминесцентный анализонкомаркермониторингстабилизацияпрогрессированиеchemotherapygastric cancersmall-cell lung cancercolorectal cancerneuroendocrine cancerovarian cancerСА-62 cancer antigenimmunochemiluminescent assaycancer markermonitoringstable diseasedisease progressionReferencesJackson S.E., Chester J.D. Personalised cancer medicine. Int J Cancer. 2015 Jul 15; 137(2): 262–6. doi: 10.1002/ijc.28940.Jackson S.E., Chester J.D. Personalised cancer medicine. Int J Cancer. 2015 Jul 15; 137(2): 262–6. doi: 10.1002/ijc.28940.Mascaux C., Tomasini P., Greiller I., Barilsi F. Personalised medicine for nonsmall cell lung cancer. Eur Respir Rev. 2017 Nov 15; 26(146). pii: 170066. doi: 10.1183/16000617.0066-2017.Mascaux C., Tomasini P., Greiller I., Barilsi F. Personalised medicine for nonsmall cell lung cancer. 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The authors declare that there are no conflicts of interest present.