Use of TPS and CA 15-3 assays for monitoring chemotherapy in metastatic breast cancer patients.
TPS and CA 15-3 have been applied for monitoring treatment in patients with advanced breast cancer and the relationship between the initial marker levels and the changes of the markers during chemotherapy has been established. Both markers have demonstrated high sensitivity for detecting visceral and bone metastases in the patients (90-95%) compared to soft tissues and locally advanced disease (45-50%). The marker combination, TPS and CA15-3, showed the highest sensitivity for detecting bone/visceral metastases (98%) and soft tissue/locally advanced metastases (75%). TPS showed a more frequent decrease in marker level (> 50%) compared to CA 15-3 as well as the highest correlation (68%) to the clinically confirmed events CR, PR compared to CA 15-3 (54%). In the subgroup of metastatic breast cancer patients, demonstrating increased marker levels (> 25%) during follow-up, TPS showed the highest correlation compared to the clinically confirmed progressive disease. In the subgroup of patients with clinically confirmed progression, contemporary measurements of the marker values resulted in correlation with the clinical findings in 78% for TPS and 58% for CA 15-3. TPS appears to be superior to CA 15-3 for follow-up of metastatic breast cancer patients. TPS and CA 15-3 marker increase preceded the clinical and/or radiological signs of distant metastases in most of the patients; 1.5 and 1.1 months, respectively. The time elapsed between tumor marker increase and clinically confirmed progression was very short, which is also related to the frequent follow-up visits for metastatic breast cancer patients receiving chemotherapy. TPS appears to indicate the changes in the disease state earlier than clinical criteria or than the established tumor burden markers. The simultaneous determination of TPS and CA 15-3 provided additive information in advanced breast cancer patients and might guide management decisions in the individual patients.
Einarsson
R
R
IDL Biotech, P.O. Box 11151, S-16811 Bromma, Sweden.
Lindman
H
H
Bergh
J
J
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D018396:Mucin-1 / Q000032:analysis*; D009362:Neoplasm Metastasis; D010455:Peptides / Q000032:analysis*; D011379:Prognosis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D018396:Mucin-1; D010455:Peptides; C089984:tissue polypeptide specific antigen