Effect of neoadjuvant chemotherapy on the serum levels of bone turnover markers in women with early-stage breast cancer.
BACKGROUND
To evaluate effects of neoadjuvant chemotherapy on the bone turnover markers of preoperational breast cancer patients.


METHODS
Forty-one breast cancer patients (29 premenopausal and 12 postmenopausal) and 60 healthy women (30 premenopausal and 30 postmenopausal) aged 30-64 years, were evaluated for their bone status. Serum levels of the bone formation markers PINP and BAP, as well as the resorption markers ICTP and β-Crosslaps in addition to E2, FSH, 25(OH)D and PTH were measured at the initial diagnosis and at 24 hours after each four chemotherapy cycles. BMD T-scores were determined in 12 patients 6 months after the neoadjuvant chemotherapies.


RESULTS
The baseline levels of both bone formation and resorption markers in premenopausal patients were higher than in premenopausal healthy women (p<0.05), while no statistic difference was observed between postmenopausal patients and postmenopausal healthy women. Regardless of the menopausal status, chemotherapy increased the ICTP and β-Crosslaps levels (p<0.05), but decreased the BAP and PINP levels (p<0.05), the later one significantly more with Taxane medication (p<0.01, p<0.05). Chemotherapy caused significant decreases of 25(OH)D levels in premenopausal (p<0.01) and postmenopausal (p<0.05) patients, however, did not affect the PTH concentrations. In premenopausal patients the E2 level decreased, while the FSH level increased after chemotherapy (p<0.05). Patients with pronounced ICTP and β-Crosslaps combined with reduced BAP and PINP serum concentrations after neoadjuvant chemotherapies were prone to develop osteoporosis 6 month later.


CONCLUSIONS
Neoadjuvant chemotherapy appeared to promote bone resorption and inhibit bone formation in both postmenopausal and premenopausal early-stage breast patients.
Department of Clinical Laboratory, Peking University Cancer Hospital and Institute, Beijing, China.
YangYang
Y
Chen
Department of Clinical Laboratory, Peking University Cancer Hospital and Institute, Beijing, China.
GuoBin
G
Xu
Department of Breast Surgery, Peking University Cancer Hospital and Institute, Beijing, China.
Feng
F
Yang
D000328:Adult; D016723:Bone Remodeling; D001943:Breast Neoplasms / Q000097:blood / Q000628:therapy; D003094:Collagen / Q000097:blood*; D024042:Collagen Type I / Q000097:blood*; D005260:Female; D020662:Guanine Nucleotide Exchange Factors / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood*; D011347:Procollagen / Q000097:blood*
D024042:Collagen Type I; D020662:Guanine Nucleotide Exchange Factors; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C418483:SIL1 protein, human; C052929:collagen type I trimeric cross-linked peptide; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; C047202:procollagen Type I N-terminal peptide; D003094:Collagen