Clinical significance of a serum CA15-3 surge and the usefulness of CA15-3 kinetics in monitoring chemotherapy response in patients with metastatic breast cancer

Abstract

One hundred and twenty-two patients in whom the CA 15-3 level showed either a decline (92 patients) or an acute surge followed by a decline (30 patients) after chemotherapy were included. The clinical characteristics between the two groups and the CA 15-3 kinetics using receiver operating characteristic curves were analyzed. Patients with a surge had a significantly higher risk of disease progression than patients without a surge (P = 0.004; odds ratio 2.62; 95% CI 1.45-4.72). The clinicopathologic characteristics were significantly different between the two groups with respect to the distribution of ER, PR, and HER2 status, relapse-free survival, and the severity and extent of the involved organs. For patients with a surge, a CA 15-3 slope threshold > -0.0038 was chosen with a sensitivity of 80.0% and a specificity of 80.4%. The area under the curve was 0.847 (95% CI 0.771-0.906; P = 0.0001). A significant correlation between PFS and CA 15-3 slope was shown with Cox-regression modeling (P = 0.036; hazard ratio [HR], 2.1; 95% CI 1.01-4.14).These kinetics may serve as a good predictive marker of treatment response and response duration.

Prognostic value of vascular endothelial growth factor and hypoxia-inducible factor 1α in canine malignant mammary tumors

“…Additionally, there was a significant increase of VEGF serum concentration in female dogs with malignant mammary tumors compared to the control group. Serum tumor markers play an important role in the early diagnostic, prognostic determination, specific therapeutic response prediction, precocious detection of tumor recurrence after surgery, and follow-up in advanced disease therapy (43,44). In this context, the VEGF is considered an important indicator of the development of cancer, and its serum levels can be used to estimate tumor progression (45).…”

“…Results showing a correlation of the role of HIF-1α in cancer progression in the literature are controversial, as it is known that HIF-1α expression is increased with tumor growth because larger tumors are generally more hypoxic than smaller ones (63). However, depending on the severity of hypoxic stimulus, HIF-1α serves as a pro-death gene capable of promoting apoptosis and cell death (43). Under conditions of severe hypoxia cells seem to survive, initiating a cascade of events leading to apoptosis and cell death, thus leading to a reduction in tumor progression (42).…”

Blood-based biomarkers in breast cancer: From proteins to circulating tumor cells to circulating tumor DNA

“…48,52,53 These transient increases are usually not related to tumor progression but appear to be result from therapy-mediated apoptosis or necrosis of tumor cells. However, in one study, patients displaying a surge were found to have a significantly higher risk of disease progression than patients without a surge.…”

“…However, in one study, patients displaying a surge were found to have a significantly higher risk of disease progression than patients without a surge. 53 As with biomarkers during postoperative surveillance, the optimum frequency for measurement when monitoring treatment in advanced breast cancer is unclear. According to the European Group on Tumor Markers (EGTM) panel, biomarkers should be determined before every course of chemotherapy and at 3-month intervals for patients receiving hormone therapy.…”

Un « effet-pointe » troublant sur l’hCG dosé au cours de la chimiothérapie de rattrapage d’une tumeur trophoblastique chez une jeune femme

“…Il concerne 20 à 30 % des patients [10,11] et survient dans les 15 jours environ après la mise en route de la chimiothérapie [12,13].…”