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Tumor Biology

, Volume 37, Issue 10, pp 13769–13775 | Cite as

CA27.29 as a tumour marker for risk evaluation and therapy monitoring in primary breast cancer patients

  • Brigitte Rack
  • Julia Jückstock
  • Elisabeth Trapp
  • Tobias Weissenbacher
  • Marianna Alunni-Fabbroni
  • Amelie Schramm
  • Peter Widschwendter
  • Krisztian Lato
  • Thomas Zwingers
  • Ralf Lorenz
  • Hans Tesch
  • Andreas Schneeweiss
  • Peter Fasching
  • Sven Mahner
  • Matthias W. Beckmann
  • Werner Lichtenegger
  • Wolfgang Janni
  • For the SUCCESS Study Group
Original Article

Abstract

Several trials showed that tumour markers are associated with an impaired prognosis for breast cancer. Whether earlier treatment can improve the course of the disease remains controversial. The SUCCESS Trial compares FEC (500/100/500)-docetaxel (100) vs. FEC (500/100/500)-docetaxel/gemcitabine (75/2000) as well as 2 vs. 5 years of zoledronate in high-risk primary breast cancer patients. In 2669 patients, CA27.29 was measured before and after chemotherapy with the ST AIA-PACK CA27.29 reagent for the AIA-600II automated enzyme immunoassay (Tosoh Bioscience, Belgium). Values above 31 U/ml were considered positive. Of the patients, 7.6 % (n = 202, mean 19, range 3–410) and 19.1 % (n = 511, mean 21, range 3–331) had elevated marker levels before and after chemotherapy, respectively. Of the patients, 4.9 and 78 % showed elevated and low CA27.29, respectively, at both time points. After treatment, 35 % of the pre-therapy positive patients were negative, and 15 % of the initially negative patients became positive. The correlation between both time points was significant (p < 0.0001). No correlations among nodal status, grading, hormonal status, HER2 status and CA27.29 levels were found. However, tumour size (p = 0.02), older age (p < 0.001) and post-menopausal status (p = 0.006) were significantly associated with higher CA27.29 levels. Before treatment, the prevalence of elevated CA27.29 was equally distributed between both treatment arms, whereas after chemotherapy, 13.7 % of the patients in the FEC-doc arm showed an increased level vs. 25.4 % of the patients in the FEC-doc/gemcitabine arm (p < 0.0001). However, we could not show a significant association between the G-CSF application (yes vs. no) and CA27.29 status before/after chemotherapy (p = 0.75). These results indicate a close relationship between CA27.29 levels and tumour mass. Increased values after the completion of chemotherapy might be attributed to treatment effects and should be considered with caution.

Keywords

Breast cancer Tumour marker CA27.29 Chemotherapy Treatment monitoring 

Notes

Acknowledgments

This translational research, as part of the SUCCESS Trial, was supported by AstraZeneca, Chugai, Lilly, Novartis, Sanofi-Aventis and Tosoh Bioscience.

Compliance with ethical standards

The study was approved by all of the involved ethical boards in Germany and complied with the Declaration of Helsinki guidelines.

Funding

B. Rack and J. Jückstock received institutional research funding from AstraZeneca, Chugai, Lilly, Novartis and Sanofi-Aventis. H. Tesch and R. Lorenz acted as advisors for Novartis, and R. Lorenz and P. Fasching received research funding from Novartis.

Conflicts of interest

None

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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2016

Authors and Affiliations

  • Brigitte Rack
    • 1
  • Julia Jückstock
    • 1
  • Elisabeth Trapp
    • 1
  • Tobias Weissenbacher
    • 1
  • Marianna Alunni-Fabbroni
    • 1
  • Amelie Schramm
    • 2
  • Peter Widschwendter
    • 2
  • Krisztian Lato
    • 2
  • Thomas Zwingers
    • 3
  • Ralf Lorenz
    • 4
  • Hans Tesch
    • 5
  • Andreas Schneeweiss
    • 6
  • Peter Fasching
    • 7
  • Sven Mahner
    • 1
  • Matthias W. Beckmann
    • 6
  • Werner Lichtenegger
    • 8
  • Wolfgang Janni
    • 2
  • For the SUCCESS Study Group
  1. 1.Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus InnenstadtLudwig-Maximilians-Universitaet MuenchenMunichGermany
  2. 2.Universitätsfrauenklinik UlmUlmGermany
  3. 3.estimate GmbHAugsburgGermany
  4. 4.Praxis Lorenz/HeckerBraunschweigGermany
  5. 5.Praxis Prof. TeschFrankfurtGermany
  6. 6.National Center for Tumor DiseasesUniversity HospitalHeidelbergGermany
  7. 7.Universitaetsfrauenklinik ErlangenErlangenGermany
  8. 8.Frauenklinik des Universitaetsklinikums Charité Campus Virchow-KlinikumBerlinGermany

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