Cancer markers in patients receiving chemotherapy for colorectal cancer: a preliminary report.

The combination of CEA, hepatic function marker enzymes, and four acute phase reactant proteins (haptoglobin, alpha 1 antitrypsin, alpha 1 acid glycoprotein, and prealbumin) has been used to monitor patients with colorectal cancer receiving chemotherapy. In 18 patients with advanced lesions who survived at least 3 months treatment the markers predicted progression in 92% of 25 incidents of progression; the mean lead time was 2.8 months. A rising CEA was only present in 28%, but in these patients it gave a mean lead time of 4 months. In the group of 14 patients with minimal residual disease progression to clinically detectable disease has occurred in 9 of them. In these cases the markers predicted progression with a mean lead time of 6 months; in a further six patients the markers have indicated progression, but as yet their disease is not detectable, the mean lead time being at least 8.6 months. CEA and the liver enzyme markers are the most sensitive indicators of progression of the minimal residual disease group.