Clinical Relevance of the Tumor Marker CA 15.3 in the Management of Cancer Patients

Bon, Gijsbert G.; Kenemans, P.; Yedema, C.A.; Kamp, Gerard J. van; Nijman, Hans W.; Hilgers, J.

doi:10.1007/978-94-011-3780-5_14

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…• In stage III breast cancer abnormal levels of CA 15.3 have been found at diagnosis in 20% to 70% of patients 14 • Several studies aimed to assess the prognostic role of these tumor markers in breast cancer. Some of them included small groups of patients with short follow-up pe~ riods and only made univariate comparisons 21 • 22…”

Section: Discussionmentioning

confidence: 99%

Serum Markers and Prognosis in Locally Advanced Breast Cancer

Martínez‐Trufero

Lobera

Lao

et al. 2005

Tumori

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Background Locally advanced breast cancer (LABC) represents a heterogeneous subgroup of breast cancer with an often dismal outcome. Identifying prognostic factors has acquired great significance for the selection of optimal treatment in individual patients. Methods Between January 1993 and December 1997, 103 patients were treated in our institution with multimodality treatment consisting of neoadjuvant chemotherapy followed by surgery, adjuvant chemotherapy and radiotherapy; tamoxifen was added in hormone receptor-positive cases. In the search for prognostic factors well-established parameters (clinical, pathological and treatment-related) as well as new features with potential value (c-erbB-2, baseline serum levels of CA 15.3 and CEA) were included in the univariate and multivariate analysis. Results At a median follow-up of 92 months (range, 8-130), the estimated five-year cancer-specific overall survival (OS) and disease-free survival (DFS) were 71.34% and 57.7%, respectively. Among the 22 different variables studied, only 10 were significantly correlated with OS and DFS. In multivariate analysis five retained independent prognostic value for both OS and DFS: tumor grade, serum markers, features of inflammatory breast cancer (IBC), response to neoadjuvant chemotherapy and lymph node status. With cutoff values of 35 U/mL for CA 15.3 and 5 ng/mL for CEA, the probability of five-year OS (Cox hazard ratio 3.91, P = 0.0009) and DFS (Cox hazard ratio 2.40, P = 0.02) decreased from 78% to 52% and from 68% to 47%, respectively, when at least one of these markers was abnormal. Conclusions Baseline serum levels of CEA and CA 15.3 emerged from this study as strong independent predictors of outcome in LABC, whose value adds to other established prognostic factors such as postoperative nodal status, IBC, histological grade and response to neoadjuvant chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Serum Markers and Prognosis in Locally Advanced Breast Cancer

Martínez‐Trufero

Lobera

Lao

et al. 2005

Tumori

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“…With progression of cancer the mucin is strongly over-expressed in tumor cells and with loss of cell polarity, active shedding and secretion MUC1 enters the body fluids and circulation. This circulating MUC1 forms the basis of serum diagnosis in postoperative control of breast cancer patients [5], but it is also responsible for the induction of weak antibody responses to the mucin. Natural B-cell responses can also be detected in pregnant women or women after passage of one lactation phase, and were shown to provide a certain degree of survival benefit for breast cancer patients [6].…”

Section: Why Muc1?mentioning

confidence: 99%

Immunology of O-Glycosylated Proteins: Approaches to the Design of a MUC1 Glycopeptide-Based Tumor Vaccine

Hanisch¹,

Ninkovic²

2006

CPPS

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Until about 1990 there was general consent about the assumption that only protein and peptide antigens have the capacity of CD4(+) or CD8(+) T-cell stimulation. Since about ten years evidence is now accumulating that carbohydrate-peptide epitopes do play a role in classical MHC-mediated immune responses. This holds true for glycopeptides, where the glycan chain is short and not located at an "anchor residue" needed for MHC interaction. T-cell recognition of O-glycosylated peptides is potentially of high biomedical significance, because it can mediate the immune protection against microorganisms, the vaccination in anti-tumor therapies, but also some aspects of autoimmunity. The epithelial type 1 transmembrane mucin MUC1 is established as a marker for monitoring recurrence of breast cancer and is a promising target for immunotherapeutic strategies to treat cancer by active specific immunization. Natural human immune responses to the tumor-associated glycoforms of the mucin indicate that antibody reactivities are more directed to glycopeptide than to non-glycosylated peptide epitopes. To overcome the weak immunogenicity of the natural target, heavily O-glycosylated MUC1, the question was addressed whether O-linked glycans remain intact during processing in the MHC class II pathway and interfere with endosomal processing and peptide presentation. Attempts were made to define on a biochemical level the structural requirements for an efficient endosomal proteolysis catalyzed by cathepsin L in antigen-presenting cells. Evidence based on work with CD4(+) T-hybridomas confirms that O-glycopeptides can be effectively presented to T-cells and that glycans can form integral parts of the TCR defined epitopes. Similar approaches are currently followed in the MHC class I pathway which aim at the identification of immunogenic glycopeptides generated by immunoproteasomes.

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“…To increase the survival of pa tients with this disease, different therapeutic strategies are applied, based on a wide vari ety of factors of which the most significant are early diagnosis of relapse and metastasis and assessment of the possible development of the disease. For several years, the quantifi cation of the serum levels of the tumour marker CA 15-3 has been an extremely use ful tool for the oncologist and gynaecologist for conducting a more comprehensive follow up of the patient and detecting relapses be fore any clinical symptom appears [7], Con sequently, the number of CA 15-3 measure ments made today by a laboratory is ex tremely important, and quantification of the tumour marker requires automated and reli able methods. Our first aim was to assess the purely ana lytical features of the new assay.…”

Section: Discussionmentioning

confidence: 99%

Analytical and Clinical Evaluation of a Procedure for Measuring CA 15-3 in the IMx Analyser

Ortega

Maestro²,

Encabo³

et al. 1996

Tumor Biol

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CA 15-3 is the most widely used tumour marker in the follow-up of patients with breast cancer. Its postoperative blood level is closely related to the response to the treatment applied and to the evolution of the disease. In this study, we assessed both the clinical and analytical features of a new microparticle enzyme immunoassay for CA 15-3 quantification in the Abbott IMx system. In the precision study, the coefficients of variation within runs, between runs and between laboratories were 3.5,5.1 and 6.5% or less, respectively. The analytical sensitivity of the assay was 0.11 U/ml. Linear regression analyses of the IMx CA 15-3 assay with the Centocor and CIS CA 15-3 RIAs gave correlation coefficients of 0.88 and 0.95, respectively. The upper limit of the reference range, obtained from serum of healthy women, was 27.3 U/ml, while the ROC curve analysis for patients with active breast cancer compared to patients with no evidence of the disease gave an optimum cutoff of 33 U/ml (sensitivity 0.76 and specificity 0.87). The overall agreement of the three methods was over 90%.

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Clinical Relevance of the Tumor Marker CA 15.3 in the Management of Cancer Patients

Cited by 9 publications

References 26 publications

Serum Markers and Prognosis in Locally Advanced Breast Cancer

Serum Markers and Prognosis in Locally Advanced Breast Cancer

Immunology of O-Glycosylated Proteins: Approaches to the Design of a MUC1 Glycopeptide-Based Tumor Vaccine

Analytical and Clinical Evaluation of a Procedure for Measuring CA 15-3 in the IMx Analyser

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