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

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Tumor Biology

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.

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References

  1. Holleczek B, Brenner H. Trends of population-based breast cancer survival in Germany and the US: decreasing discrepancies, but persistent survival gap of elderly patients in Germany. BMC Cancer. 2012;12:317. doi:10.1186/1471-2407-12-317.:317-12.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Allemani C, Sant M, Weir HK, et al. Breast cancer survival in the US and Europe: a CONCORD high-resolution study. Int J Cancer. 2013;132:1170–81.

    Article  CAS  PubMed  Google Scholar 

  3. Allemani C, Minicozzi P, Berrino F, et al. Predictions of survival up to 10 years after diagnosis for European women with breast cancer in 2000-2002. Int J Cancer. 2013;132:2404–12.

    Article  CAS  PubMed  Google Scholar 

  4. Ebeling FG, Stieber P, Untch M, et al. Serum CEA and CA 15-3 as prognostic factors in primary breast cancer. Br J Cancer. 2002;86:1217–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gion M, Boracchi P, Dittadi R, et al. Prognostic role of serum CA15.3 in 362 node-negative breast cancers. An old player for a new game. Eur J Cancer. 2002;38:1181–8.

    Article  CAS  PubMed  Google Scholar 

  6. Kumpulainen EJ, Keskikuru RJ, Johansson RT. Serum tumor marker CA 15.3 and stage are the two most powerful predictors of survival in primary breast cancer. Breast Cancer Res Treat. 2002;76:95–102.

    Article  CAS  PubMed  Google Scholar 

  7. Brouckaert O, Laenen A, Wildiers H, et al. The prognostic role of preoperative and (early) postoperatively change in CA15.3 serum levels in a single hospital cohort of primary operable breast cancers. Breast. 2013;22:254–62.

    Article  CAS  PubMed  Google Scholar 

  8. Sandri MT, Salvatici M, Botteri E, et al. Prognostic role of CA15.3 in 7942 patients with operable breast cancer. Breast Cancer Res Treat. 2012;132:317–26.

    Article  CAS  PubMed  Google Scholar 

  9. Keshaviah A, Dellapasqua S, Rotmensz N, et al. CA15-3 and alkaline phosphatase as predictors for breast cancer recurrence: a combined analysis of seven international breast cancer study group trials. Ann Oncol. 2007;18:701–8.

    Article  CAS  PubMed  Google Scholar 

  10. Kokko R, Holli K, Hakama M. Ca 15-3 in the follow-up of localised breast cancer: a prospective study. Eur J Cancer. 2002;38:1189–93.

    Article  CAS  PubMed  Google Scholar 

  11. Nicolini A, Tartarelli G, Carpi A, et al. Intensive post-operative follow-up of breast cancer patients with tumour markers: CEA, TPA or CA15.3 vs MCA and MCA-CA15.3 vs CEA-TPA-CA15.3 panel in the early detection of distant metastases. BMC Cancer. 2006;6:269.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Incoronato M, Mirabelli P, Catalano O, et al. CA15-3 is a useful serum tumor marker for diagnostic integration of hybrid positron emission tomography with integrated computed tomography during follow-up of breast cancer patients. BMC Cancer. 2014;14:356. doi:10.1186/1471-2407-14-356.:356-14.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Harris L, Fritsche H, Mennel R, et al. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol. 2007;25:5287–312.

    Article  CAS  PubMed  Google Scholar 

  14. Singletary ES, Allred C, Ashley P, et al. Revision of the American Joint Committee on cancer staging system for breast cancer. J Clin Oncol. 2002;20:3628–36.

    Article  PubMed  Google Scholar 

  15. le Doussal V, Tubiana HM, Friedman S, Hacene K, Spyratos F, Brunet M. Prognostic value of histologic grade nuclear components of Scarff-bloom-Richardson (SBR). An improved score modification based on a multivariate analysis of 1262 invasive ductal breast carcinomas. Cancer. 1989;64:1914–21.

    Article  PubMed  Google Scholar 

  16. Sinn BV, von Minckwitz G, Denkert C, et al. Evaluation of mucin-1 protein and mRNA expression as prognostic and predictive markers after neoadjuvant chemotherapy for breast cancer. Ann.Oncologia. 2013;24:2316–24.

    Article  CAS  Google Scholar 

  17. Paoletti C, Hayes DF. Molecular testing in breast cancer. AnnuRevMed. 2014;65:95–110. doi:10.1146/annurev-med-070912-143853.:95-110.

    CAS  Google Scholar 

  18. Park BW, JW O, Kim JH, et al. Preoperative CA 15-3 and CEA serum levels as predictor for breast cancer outcomes. Ann Oncol. 2008;19:675–81.

    Article  PubMed  Google Scholar 

  19. Kiang DT, Greenberg LJ, Kennedy BJ. Tumor marker kinetics in the monitoring of breast cancer. Cancer. 1990;65:193–9.

    Article  CAS  PubMed  Google Scholar 

  20. Yasasever V, Dincer M, Camlica H, Karaloglu D, Dalay N. Utility of CA 15-3 and CEA in monitoring breast cancer patients with bone metastases: special emphasis on “spiking” phenomena. Clin Biochem. 1997;30:53–6.

    Article  CAS  PubMed  Google Scholar 

  21. Pentheroudakis G, Malamou-Mitsi V, Briasoulis E, et al. The neutrophil, not the tumor: serum CA 15-3 elevation as a result of granulocyte—colony-stimulating factor-induced neutrophil MU1C overexpression and neutrophilia in patients with breast carcinoma receiving adjuvant chemotherapy. Cancer. 2004;101:1767–75.

    Article  CAS  PubMed  Google Scholar 

  22. Ghosh SK, Pantazopoulos P, Medarova Z, Moore A. Expression of underglycosylated MUC1 antigen in cancerous and adjacent normal breast tissues. Clin Breast Cancer. 2013;13:109–18.

    Article  CAS  PubMed  Google Scholar 

  23. Demichelis SO, Alberdi CG, Servi WJ, Isla-Larrain MT, Segal-Eiras A, Croce MV. Comparative immunohistochemical study of MUC1 and carbohydrate antigens in breast benign disease and normal mammary gland. Appl Immunohistochem Mol Morphol. 2010;18:41–50.

    Article  CAS  PubMed  Google Scholar 

  24. Bon GG, van Kamp GJ, Verstraeten RA, Mensdorff-Pouilly S, Hilgers J, Kenemans P. Quantification of MUC1 in breast cancer patients. A method comparison study. Eur J Obstet Gynecol Reprod Biol. 1999;83:67–75.

    Article  CAS  PubMed  Google Scholar 

  25. Duffy MJ, Duggan C, Keane R, et al. High preoperative CA 15-3 concentrations predict adverse outcome in node-negative and node-positive breast cancer: study of 600 patients with histologically confirmed breast cancer. Clin Chem. 2004;50:559–63.

    Article  CAS  PubMed  Google Scholar 

  26. Lynch DM, Rogers PE, Love JC, et al. Clinical evaluation comparing AxSYM CA 15-3, IMx CA 15-3 and Truquant BRTM RIA. Tumour Biol. 1998;19:421–38.

    Article  CAS  PubMed  Google Scholar 

  27. Gion M, Mione R, Leon AE, et al. CA27.29: a valuable marker for breast cancer management. A confirmatory multicentric study on 603 cases. Eur J Cancer. 2001;37:355–63.

    Article  CAS  PubMed  Google Scholar 

  28. Grassetto G, Fornasiero A, Otello D, et al. 18F-FDG-PET/CT in patients with breast cancer and rising Ca 15-3 with negative conventional imaging: a multicentre study. Eur J Radiol. 2011;80:828–33.

    Article  PubMed  Google Scholar 

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Acknowledgments

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

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Authors and Affiliations

  1. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe Campus Innenstadt, Ludwig-Maximilians-Universitaet Muenchen, Maistr. 11, 80337, Munich, Germany

    Brigitte Rack, Julia Jückstock, Elisabeth Trapp, Tobias Weissenbacher, Marianna Alunni-Fabbroni & Sven Mahner

  2. Universitätsfrauenklinik Ulm, Prittwitzstrasse, 43 89075, Ulm, Germany

    Amelie Schramm, Peter Widschwendter, Krisztian Lato & Wolfgang Janni

  3. estimate GmbH, Konrad-Adenauer-Allee 1, 86150, Augsburg, Germany

    Thomas Zwingers

  4. Praxis Lorenz/Hecker, Hagenmarkt 19-20, 38100, Braunschweig, Germany

    Ralf Lorenz

  5. Praxis Prof. Tesch, Im Prüfling 17-19, 60389, Frankfurt, Germany

    Hans Tesch

  6. National Center for Tumor Diseases, University Hospital, Im Neuenheimer Feld 460, D-69120, Heidelberg, Germany

    Andreas Schneeweiss & Matthias W. Beckmann

  7. Universitaetsfrauenklinik Erlangen, Universitaetsstrasse 21-23, D-, 91054, Erlangen, Germany

    Peter Fasching

  8. Frauenklinik des Universitaetsklinikums Charité Campus Virchow-Klinikum, Augustenburger Platz 1, D-, 13353, Berlin, Germany

    Werner Lichtenegger

Authors
  1. Brigitte Rack
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  2. Julia Jückstock
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  3. Elisabeth Trapp
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  4. Tobias Weissenbacher
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  5. Marianna Alunni-Fabbroni
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  6. Amelie Schramm
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  7. Peter Widschwendter
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  8. Krisztian Lato
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  9. Thomas Zwingers
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  10. Ralf Lorenz
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  11. Hans Tesch
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  12. Andreas Schneeweiss
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  13. Peter Fasching
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  14. Sven Mahner
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  15. Matthias W. Beckmann
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  16. Werner Lichtenegger
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  17. Wolfgang Janni
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Consortia

For the SUCCESS Study Group

Corresponding author

Correspondence to Brigitte Rack.

Ethics declarations

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

Additional information

The authors are sincerely grateful to Heidi Coleman for her editorial support

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Rack, B., Jückstock, J., Trapp, E. et al. CA27.29 as a tumour marker for risk evaluation and therapy monitoring in primary breast cancer patients. Tumor Biol. 37, 13769–13775 (2016). https://doi.org/10.1007/s13277-016-5171-2

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  • DOI: https://doi.org/10.1007/s13277-016-5171-2

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