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Elevated serum P1NP predicts development of bone metastasis and survival in early-stage breast cancer

  • Epidemiology
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Abstract

Bone is the most common site of metastasis of breast cancer, affecting most women with advanced disease. Procollagen type I N-terminal propeptide (P1NP), osteocalcin, CTX, and IL-6 are markers of bone turnover. Our objective was to determine whether serum levels of these proteins have clinical utility as predictors of breast cancer metastasis to bone. Blood was collected before treatment from 164 patients with stage I–III breast cancer from September 2001 to December 2008. Serum levels of P1NP, CTX, IL-6, and OC were measured using an automated immunoassay system. Correlations of the levels of these markers with time to bone metastasis development and with overall survival (OS) rate were assessed using Cox proportional hazards regression analysis and the Kaplan–Meier method. Fifty-five patients with stage I–III disease at the time of blood sample collection subsequently experienced metastasis to bone. A baseline P1NP level of at least 75 ng/mL predicted increased risk of bone metastasis (hazard ratio, 2.7 [95 % confidence interval, 1.2–6.0]; P = 0.031) and a poor OS rate (P = 0.031). Serum P1NP levels at or above 75 ng/mL correlate with a short time to development of bone metastasis and low overall survival in patients with stage I–III breast cancer.

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Acknowledgments

We thank our patients for providing the blood samples for our biomarker research. This study was supported by an investigator-initiated grant provided by Roche Diagnostics to Francisco J. Esteva. This research is supported in part by the National Institutes of Health through MD Anderson’s Cancer Center Support Grant CA016672.

Conflict of interest

The authors made no disclosures.

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Author notes

  1. Windy Dean-Colomb

    Present address: University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA

Authors and Affiliations

  1. Department of Breast Medical Oncology, Unit 1354, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA

    Windy Dean-Colomb, Elliana Young, Stacy L. Moulder, Nuhad Ibrahim, Lajos Pusztai, Daniel Booser, Vicente Valero, Gabriel N. Hortobagyi & Francisco J. Esteva

  2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Kenneth R. Hess

  3. Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Terrie G. Gornet & Beverly C. Handy

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  1. Windy Dean-Colomb
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Correspondence to Francisco J. Esteva.

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Dean-Colomb, W., Hess, K.R., Young, E. et al. Elevated serum P1NP predicts development of bone metastasis and survival in early-stage breast cancer. Breast Cancer Res Treat 137, 631–636 (2013). https://doi.org/10.1007/s10549-012-2374-0

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  • DOI: https://doi.org/10.1007/s10549-012-2374-0

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