Ca 19-9. Funny you mentioned this. I was just reading about it last night.
Here's an ok read that may provide a little insight (for some) on tumor markers. Specifically CA 19-9.
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Tumor Markers for Pancreatic Cancer
Tumor markers are just what they sound like, a way to mark a tumor. In other words, they can tell us, ideally, what a tumor is doing: growing or not growing.
You noticed I said, Ideally.
Exactly… there’s nothing ideal about the current tumor marker tests. But they’re all we’ve got right now and they are definitely better than nothing.
Let me explain the science behind them to make it a little clearer.
Most, if not all, cancers produce substances into our bodies. Some cancers produce proteins, some actually shed tumor cells. These substances can be found in either our blood, our urine, or in other body tissues. Tumor markers are tests to determine how much of these substances are floating around our body. The more tumor substance found in the body then it stands to reason, that the more active the cancer is. “Ideally.”
Unfortunately these tests are still a long way from being foolproof. There can be false positives and false negatives. Many other factors can alter the marker results, so most doctors use them as just one test among many to stage cancers and determine growth and advancement of the disease.
The most common tumor marker for pancreatic cancer is the CA 19-9. It was first developed to detect colon cancer, but has been found to also be sensitive for pancreatic cancer.
Ca 19-9 is a substance that is released into the blood by the pancreatic cancer cells. This marker test is performed by taking a small amount of blood and testing it.
A normal Ca 19-9 in a healthy individual can range from 0-37 U/ml. So anything higher than 37 should prompt a more thorough investigation. It sounds like a perfect screening test doesn’t it? Unfortunately, by the time blood levels are high enough to be consistently detected by this blood test, the cancer is usually in advanced stages. So, no, not a great screening test.
On the other hand, the Ca19-9 test is fairly accurate in evaluating how a patient is responding to the cancer treatment or chemotherapy. If the chemo is knocking back the cancer and slowing the growth, then the tumor won’t be shedding so much of the substance, resulting in lower Ca 19-9 figures. If the chemo is not working then obviously the tumor will be more active, shedding more substance, and having higher Ca 19-9 numbers.
One word of caution here. Don’t get caught in the trap of worrying over every spike in the marker test. Doctors generally are looking for trends over a period of time rather than one elevated test to determine success or failure of your treatment.
A second word of caution. There are a small number of people whose pancreatic cancers do not shed the Ca 19-9 substance. Their tumor marker test for Ca 19-9 will always come back low, irregardless of whether the cancer is growing or gone. If you fall into this group, your doctor will most likely opt for more frequent CT scans and evaluations to monitor your progress.
And finally, a third word of caution. (see what I mean? This tumor marker test is definitely not foolproof!). It’s important to know that the Ca 19-9 test can be elevated for other reasons besides pancreatic cancer. Among these are gallstones, pancreatitis (inflammation of the pancreas, not related to cancer), cirrhosis, and cholecystitis.
Mom is a good example of the erratic behavior of the Ca19-9 test. Her numbers have gone up and down like a roller coaster. Her initial tumor marker test was 404. Chemotherapy and radiation have gotten the test down at one point to a low of 84. But it’s been as high as 1474, after a 2 month hiatus from chemo due to a nasty gall bladder surgery. Her doctor uses the CA 19-9 test mainly to see how treatment is progressing. So far, the Gemzar keeps knocking the tumor marker back down. When the marker doesn’t respond to the chemo, we will know it’s time to move on to another treatment.
We’re thankful there are ways of monitoring mom’s cancer, even if the marker test is a tad unreliable. Certain cancers don’t even have that.
Funny, a year ago, being thankful for a blood test for cancer wasn’t even on my radar screen. So glad it was on the researcher’s. Who knows? In another decade maybe we’ll be light years ahead in detecting and monitoring pancreatic cancer. Praying that it will be so…
Hi Flash. I read his statement as being off as well.
It's defined on the clinical trials site as follows:
Primary Outcome Measures:
Maximum Tolerated Dose (MTD) of Kevetrin [ Time Frame: up to 6 months ] [ Designated as safety issue: Yes ]
A dose will be declared the MTD if at least 1 patient out of 6 patients experience a dose limiting toxicity (DLT) at the highest dose level below the maximally administered dose. Once an MTD has been established, up to 12 additional patients may be enrolled at the MTD dose level for confirmation of safety. The maximally administered dose is if 1 or more of 6 patients experience a DLT.
Dose Limiting Toxicities (DLT) of Kevetrin. [ Time Frame: up to 4 weeks ] [ Designated as safety issue: Yes ]
The definition of dose limiting toxicity (DLT) is in accord with the NCI Common Terminology Criteria for Adverse Events v4.0 (CTCAE). Dose limiting toxicity will be defined as:
Grade 3 or 4 neutropenia complicated by fever, or greater than 38.5°C documented infection, or Grade 4 neutropenia of greater than 7 days duration
Grade 4 thrombocytopenia or grade 3 thrombocytopenia complicated by hemorrhage
Any grade greater than 3 non-hematologic toxicity unless there is clear alternative evidence that the adverse event (AE) was not caused by Kevetrin
Grade 3 diarrhea, nausea, or vomiting may be excluded from dose-limiting toxicities provided that the maximum time limit for supportive measures is 48 hours.
http://clinicaltrials.gov/ct2/show/NCT0166400...amp;rank=2
Impressive that pancreatic tumor size remained stable for over 4 months. I suspect CA 19-9 levels were also monitored and I wonder if levels trended lower. CA 19-9 is more sensitive than CEA as a tumor marker for pancreatic cancer. Very encouraging- hope we hear more good news soon.
Are you sure it is "in line." I read Dr J's version as the final stage actually attempts to cause someone to have an SAE. Not sure that is ethical.
You crack me up etrade.
CEA tumor marker is something that both my wife and mother lived and died by with both of their cancers which were non-small cell lung. In fact, any cancer patient will tell you exactly what it means. Leo's citing this pancreatic instance is huge and I only hope that it can be replicated for those afflicted with this extremely deadly form of cancer.
Nothing but good news here, have a great night.
GO CTIX!!!!!!!
Quote:
Once the MTD is established, the trial will enroll another 12 patients who meet the criteria and will look for at least 1 out of 6 to determine if any grade 3 or 4 adverse effects are observed.
If they can reproduce this the trial will be declared over.
Let me start by saying I about fell out of my F'in chair when you posted this. It's inline with what most here have been saying for some time now. I'm shell shocked.
Tell me if you agree with the following: The maximum administered dose is defined when 1 out of 6 patients experience a dose limiting toxicity. The trial then enrolls up to 12 (probably 3) more patients at the lower dosing level defined as the Maximum Tolerated Dose to confirm safety at this lower dosing level. Safety is confirmed if no dose limiting toxicity occurs at the maximum tolerated dose.
>>"Another tumor marker, CEA, was decreased and the tumor size remained stable over 4 months in a pancreatic carcinoma patient...."
I missed the above the first few times I saw the whole release. The above data point is from doses <210 mg/m2. There is now data at 210 and hopefully 350.
That is a stage 4 pancreatic cancer with a prognosis of 6 months to a year. The tumor size stabilized for 4 months would be considered a breakthrough treatment if confirmed in more patients of that tumor type. If K stabilizes growth for a cancer for which there is no other effective treatment, it will be approved as a stand alone cancer drug.
K - CTIX - Old SA article
http://m.seekingalpha.com/article/1422381-cel...ved?page=2
An old seeking alpha very informative article on Kevetrin and CTIX.
This is the article that made me invest more in CTIX some 1 1/2 years back.
We have come a long way and Kevetrin has progressed further - to C9. Hoping that some of the things said in that article come true.
The comments and the debate on this article also gives a lot of info
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You can add me as an honorary member to the family and I'd be ....honored of course.
Yes we can all agree that CTIX has a lot good going on. Invest heavily and be unimaginably rewarded.
Thanks for the response.
Thanks Dr J, that explained a lot for me.
Personally I am encouraged by these low-dose results, but given the low sample size and that the nature of cancer pathology is that it can wax and wane on its own, I can draw no conclusions on efficacy. Thank goodness for the scientific process of drug trials: it's what Phase 2 and 3 trials are for!
Gee, one monsta whale among others come to mind and it's certainly not me.............................where's biohedge?
Yes George is dangerously definitive even in the face of contradicting statements from the company itself and from the resident docs on this board. Time will tell and it is not in his financial interest to be completely correct. (Which is the only reason I have some minuscule remnant of respect for his opinion.)
Nice!
I've got 4 ophthalmic surgeons in the immediate family and all three of them have bought into CTIX. They're very enthusiastic about B-Ocular, along with everything else. (FWIW the pediatrician and the oncology nurse practitioner are in, too. Oh, and the Morgan Stanley private wealth manager
God Bless you, I'll tell her tonight about your Cellceutix thoughts as we celebrate the Sabbath, she'll like that, a divine appointment........................All the best to you and yours, Shalom.
Thanks Citrati. I think TA can have temporary validity if enough people in the market agree on a 'trend' and trade accordingly. But it has been mathematically proven that such a phenomenon would not be sustainable, just as a cartel or a ponzi scheme or a Martingale system for roulette is not sustainable; it will ultimately fail. And note just the onerous initial conditionality: first you have to assume everyone agrees on the TA pattern. Open up 10 newspapers and find 10 horoscopes for Libra. Ever notice none of them are the same?
And to push any remaining doubt aside: Do you buy CTIX because it is in a channel? Or an inverted flag pattern, or head and shoulder or whatever? Or because you assessed its potential future free cash flows and thought it is still undervalued?
Finally: all the successful investors you can name are fundamental analysts, not TA's. There is a reason for that.
I look at CTIX's stock chart. I absolutely do. And I knew CTIX would have a pullback. Of course it will. And it will again many, many times. But what I do not know, and no one here knows either, is when and how much.
Having a cancer cure / stabilization / reduction will bring so many good feelings to those who have cancer, and their loved ones-priceless-and it will be reflected in the stock price.
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