title: The objective measurement of remission and progression in metastatic breast cancer by use of serum tumour markers. European Group for Serum Tumour Markers in Breast Cancer.
abstract: An established biochemical index for monitoring therapy in patients with metastatic breast cancer was tested prospectively in a multicentre study. The index uses two serum tumour markers--carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3) along with erythrocyte sedimentation rate (ESR). 67 patients treated by either endocrine or chemotherapy had CA15-3, CEA and ESR measured at diagnosis of metastases and sequentially during therapy. Two markers, CA15-3 and CEA, were measured on a further 16 patients giving a total of 83 patients who were assessable for CA15-3 and CEA. Of the patients with CA15-3, CEA and ESR measured at diagnosis of metastases 84% (56/67) had elevation of 1 or more markers. During therapy the number with elevated marker(s) rose to 96% (64/67). Changes in the markers were in line with and often pre-dated therapeutic outcome as assessed by the International Union Against Cancer (UICC) criteria both for remission and progression. Patients without elevation of markers on diagnosis subsequently showed a rise in the marker(s) at or before documented disease progression by UICC. The 3 women in whom markers were at no time significantly elevated remain in remission. The results using CA15-3 and CEA were similar but 12% less patients were assessable. CA15-3 and CEA (with and without ESR) provide an objective method to guide therapy in patients with metastatic breast cancer.
authors.affiliation: Professional Unit of Surgery, City Hospital, Nottingham, UK. john.robertson@nottingham.ac.uk
authors.forename: J F
authors.initials: JF
authors.lastname: Robertson
authors.forename: W
authors.initials: W
authors.lastname: Jaeger
authors.forename: J J
authors.initials: JJ
authors.lastname: Syzmendera
authors.forename: C
authors.initials: C
authors.lastname: Selby
authors.forename: R
authors.initials: R
authors.lastname: Coleman
authors.forename: A
authors.initials: A
authors.lastname: Howell
authors.forename: J
authors.initials: J
authors.lastname: Winstanley
authors.forename: P E
authors.initials: PE
authors.lastname: Jonssen
authors.forename: E
authors.initials: E
authors.lastname: Bombardieri
authors.forename: J R
authors.initials: JR
authors.lastname: Sainsbury
authors.forename: H
authors.initials: H
authors.lastname: Gronberg
authors.forename: E
authors.initials: E
authors.lastname: Kumpulainen
authors.forename: R W
authors.initials: RW
authors.lastname: Blamey
mesh_terms: D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D001799:Blood Sedimentation; D001943:Breast Neoplasms / Q000097:blood / Q000175:diagnosis*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D011446:Prospective Studies; D012074:Remission Induction
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen