The objective measurement of remission and progression in metastatic breast cancer by use of serum tumour markers

Robertson, J. F. R.; Jaeger, Wolfram; Syzmendera, J J; Selby, C.; Coleman, Robert E.; Howell, Anthony; Winstanley, John; Jonssen, P.E.; Bombardieri, Emilio; Sainsbury, Jrc; Grönberg, Henrik; Kumpulainen, E.; Blamey, R.W.

doi:10.1016/s0959-8049(98)00297-4

Cited by 81 publications

(50 citation statements)

References 16 publications

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“…The usefulness of blood tumour markers in the diagnosis and monitoring of response to treatment in patients with metastatic disease is well established (Breast Speciality Group of BASO, 1999;Robertson et al, 1999;Cheung et al, 2000Cheung et al, , 2001. Much less has been written about the prognostic value of tumour markers.…”

Section: Discussionmentioning

confidence: 99%

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

et al. 2003

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The aim of this study was to identify factors that may be associated with the development of bone metastases in patients with metastatic breast carcinoma and to see if any of these factors had a bearing on subsequent survival. In total, 492 patients presented to the Nottingham City Hospital with metastatic breast carcinoma between July 1997 and December 2001. Of these, 267 patients had bone metastases at presentation with metastatic disease, 91 patients in this group had bone as their only site of metastatic disease. Sites of first presentation of metastatic disease were prospectively recorded, as were histological features of the primary tumour (tumour type, histological grade, lymph node stage, tumour size and oestrogen receptor (ER) status). The radiological features of the bone metastases, the metastasis-free interval and serological tumour marker levels at presentation with metastases were all recorded. There was a significant association between the development of bone metastases and lower grade tumours (P ¼ 0.019), ER-positive tumours (Po0.0001) and the lymph node stage of the primary tumour (P ¼ 0.047). A multivariate analysis found that metastasis-free interval, additional sites of metastatic disease other than bone, ER status and serological tumour marker levels all independently contributed to survival from time of presentation with bone metastases. British Journal of Cancer (2003) The survival of patients with metastases is variable ranging from a matter of months to many years. The ability to predict prognosis and response to treatment has a considerable impact on patient management. It is well established that oestrogen receptor (ER) status and site of presentation of metastatic disease have the greatest impact on patient survival, with additional contributions made by patient age, disease-free interval and histological grade.Bone is the most common site of metastases in patients with breast carcinoma and so patients with bone metastases make up the largest single group of patients presenting with metastatic disease. It has previously been reported that 20% of patients with bone metastases survive for more than 5 years, which emphasises the wide variation in survival seen in this group of patients (Coleman et al, 1987). The aim of this study was to identify factors that may be associated with the development of bone metastases and to see if any of these factors had any bearing on subsequent survival.We have assessed traditional factors such as ER status, histological grade, lymph node stage and size of the primary tumour, patient age, metastasis-free interval and the presence of metastases at sites other than bone. We have examined the radiological appearance of the bone metastases and looked for associations with the histological features of the tumour and patient survival. In common with other centres, we increasingly use serological tumour markers in the diagnosis and monitoring of patients with metastatic breast carcinoma. The prognostic significance of elevated tumour markers at presentation ...

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Section: Discussionmentioning

confidence: 99%

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

et al. 2003

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“…Although tumor markers alone are insufficient to evaluate therapeutic response (19), several studies suggest that tumor marker levels correlate with treatment response (3,(20)(21)(22)(23). For example, Robertson et al (3) reported that changes in the levels of tumor markers correlated with patients' therapeutic response, as assessed by imaging methods (3).…”

Section: Elevation Of Serum Cea and Ca15-3 Levels During Antitumor Thmentioning

confidence: 99%

“…For example, Robertson et al (3) reported that changes in the levels of tumor markers correlated with patients' therapeutic response, as assessed by imaging methods (3). Furthermore, reduction in CEA and CA15-3 levels predicted a positive response to systemic therapy in metastatic breast cancer patients (23).…”

Section: Elevation Of Serum Cea and Ca15-3 Levels During Antitumor Thmentioning

confidence: 99%

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Elevation of serum CEA and CA15‑3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients

Yang

Zhang

et al. 2017

Oncol Lett

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Abstract. The aim of the present study was to assess the correlation between therapeutic response and carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3) levels in advanced breast cancer patients with non-assessable lesions or stable disease (SD) according to the Response Evaluation Criteria in Solid Tumors. A total of 232 female patients with recurrent tumors following radical mastectomy were recruited, including 76 patients with non-assessable lesions and 60 patients with SD. The correlation between CEA and CA15-3 changes, progression-free survival (PFS) and therapeutic response were analyzed in the non-assessable and SD patient groups. For all subjects, the association between the patients' serum tumor markers levels and the clinical presentation of the tumor, as well as the correlation between initial tumor marker levels and PFS, were analyzed. An increase in CEA (an increment of >2 ng/ml) or CA15-3 levels (an increase of >15 U/ml) following the second cycle of treatment correlated with shorter PFS in both non-assessable and SD patients, and with poor clinical outcome in SD patients. High CA15-3 levels correlated with hormone receptor-positive tumors, multiple metastases and liver metastases. Bone metastases correlated with high levels of both CEA and CA15-3. Relatively low CEA and CA15-3 concentrations were associated with triple-negative and locally invasive tumors. High CEA and CA15-3 levels at the beginning of relapse correlated with shorter PFS. The present study illustrates that CEA and CA15-3 levels correlate with several factors in recurrent breast cancer patients. Elevated levels of CEA and CA15-3 at the beginning of relapse may predict shorter PFS. Furthermore, elevation of CEA and CA15-3 levels following the second therapeutic cycle predict poor therapeutic response in patients with non-assessable lesions and SD. Our findings suggest that alterations in CEA and CA15-3 levels can predict therapeutic response in advanced breast cancer patients.

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“…The UICC criteria includes physical examination, measurement of lesions, radiology and isotope scanning (Hayward et al, 1977). Two multi-centre trials, however, have shown that changes in serial concentrations of tumour markers correlate with therapy response based on the UICC criteria (Robertson et al, 1999;Van Dalen et al, 2004). Tampellini et al (Tampellini et al, 2006) performed a large single institution study with the aim of measuring serum CA 15.3 at baseline, and at three and six months during anthracycline-based first-line chemotherapy in 526 patients with advanced breast cancer who had been prospectively enrolled in five phase II-III trials.…”

Section: Monitoring Response To Treatment In Breast Cancermentioning

confidence: 99%

Tumour Markers and Molecular Imaging with FDG PET/CT in Breast Cancer: Their Combination for Improving the Prediction of Disease Relapse

Evangelista¹,

Baretta²,

Vinante³

et al. 2012

Positron Emission Tomography - Current Clinical and Research Aspects

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The objective measurement of remission and progression in metastatic breast cancer by use of serum tumour markers

Cited by 81 publications

References 16 publications

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

Bone metastases from breast carcinoma: histopathological – radiological correlations and prognostic features

Elevation of serum CEA and CA15‑3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients

Tumour Markers and Molecular Imaging with FDG PET/CT in Breast Cancer: Their Combination for Improving the Prediction of Disease Relapse

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