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. 1990 Jan;61(1):126–132. doi: 10.1038/bjc.1990.26

An objective biochemical assessment of therapeutic response in metastatic breast cancer: a study with external review of clinical data.

M R Williams 1, A Turkes 1, D Pearson 1, K Griffiths 1, R W Blamey 1
PMCID: PMC1971340  PMID: 2137007

Abstract

A series of tumour related markers have been examined in 179 patients receiving primary endocrine therapy for metastatic breast cancer. Significant correlations between therapeutic response (UICC criteria after 6 months of treatment) and appropriate alterations in serum concentrations of carcinoembryonic antigen, ferritin, c-reactive protein, orosomucoid and the erythrocyte sedimentation rate, have been observed when changes in these markers were examined only at high serum concentrations. By combining these five markers a 'therapeutic index' of response has been devised which can be employed at an early stage of treatment in more than 90% of patients, giving an overall sensitivity/specificity of 90%/78% for therapeutic response or disease stabilisation over a 6-month period. The design of an objective measurement of response, which is easy to perform, has the potential to replace the existing, largely subjective. UICC criteria for retrospective judgement of response, and may also be used to direct systemic endocrine therapy.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Begent R. H., Bagshawe K. D. The management of high-risk choriocarcinoma. Semin Oncol. 1982 Jun;9(2):198–203. [PubMed] [Google Scholar]
  2. Borthwick N. M., Wilson D. W., Bell P. A. Carcinoembryonic antigen (CEA) in patients with breast cancer. Eur J Cancer. 1977 Feb;13(2):171–176. doi: 10.1016/0014-2964(77)90196-7. [DOI] [PubMed] [Google Scholar]
  3. Caffier H., Brandau H. Serum tumor markers in metastatic breast cancer and course of disease. Cancer Detect Prev. 1983;6(4-5):451–457. [PubMed] [Google Scholar]
  4. Campbell F. C., Blamey R. W., Woolfson A. M., Elston C. W., Hosking D. J. Calcium excretion (CaE) in metastatic breast cancer. Br J Surg. 1983 Apr;70(4):202–204. doi: 10.1002/bjs.1800700405. [DOI] [PubMed] [Google Scholar]
  5. Chu T. M., Nemoto T. Evaluation of carcinoembryonic antigen in human mammary carcinoma. J Natl Cancer Inst. 1973 Oct;51(4):1119–1122. doi: 10.1093/jnci/51.4.1119. [DOI] [PubMed] [Google Scholar]
  6. Coombes R. C., Dady P., Parsons C., McCready V. R., Ford H. T., Gazet J. C., Powles T. J. Assessment of response of bone metastases to systemic treatment in patients with breast cancer. Cancer. 1983 Aug 15;52(4):610–614. doi: 10.1002/1097-0142(19830815)52:4<610::aid-cncr2820520406>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  7. Coombes R. C., Powles T. J., Gazet J. C., Ford H. T., Nash A. G., Sloane J. P., Hillyard C. J., Thomas P., Keyser J. W., Marcus D. A biochemical approach to the staging of human breast cancer. Cancer. 1977 Aug;40(2):937–944. doi: 10.1002/1097-0142(197708)40:2<937::aid-cncr2820400252>3.0.co;2-d. [DOI] [PubMed] [Google Scholar]
  8. Cove D. H., Woods K. L., Smith S. C., Burnett D., Leonard J., Grieve R. J., Howell A. Tumour markers in breast cancer. Br J Cancer. 1979 Nov;40(5):710–718. doi: 10.1038/bjc.1979.251. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. DeMartini A. L., Buzdar A. U., Blumenschein G. R. Osteoblastic metastatic disease as a therapeutic response to adjuvant chemotherapy in breast cancer. J Surg Oncol. 1983 May;23(1):32–34. doi: 10.1002/jso.2930230109. [DOI] [PubMed] [Google Scholar]
  10. Haagensen D. E., Jr, Barry W. F., Jr, McCook T. A., Giannola J., Ammirata S., Wells S. A., Jr The value of serial plasma levels of carcinoembryonic antigen and gross cyst disease fluid protein in patients with breast carcinoma and osseous metastases. Ann Surg. 1980 May;191(5):599–603. doi: 10.1097/00000658-198005000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hayward J. L., Carbone P. P., Heuson J. C., Kumaoka S., Segaloff A., Rubens R. D. Assessment of response to therapy in advanced breast cancer: a project of the Programme on Clinical Oncology of the International Union Against Cancer, Geneva, Switzerland. Cancer. 1977 Mar;39(3):1289–1294. doi: 10.1002/1097-0142(197703)39:3<1289::aid-cncr2820390340>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  12. Hortobagyi G. N., Libshitz H. I., Seabold J. E. Osseous metastases of breast cancer. Clinical, biochemical, radiographic, and scintigraphic evaluation of response to therapy. Cancer. 1984 Feb 1;53(3):577–582. doi: 10.1002/1097-0142(19840201)53:3<577::aid-cncr2820530335>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  13. Howell A., Barnes D. M., Harland R. N., Redford J., Bramwell V. H., Wilkinson M. J., Swindell R., Crowther D., Sellwood R. A. Steroid-hormone receptors and survival after first relapse in breast cancer. Lancet. 1984 Mar 17;1(8377):588–591. doi: 10.1016/s0140-6736(84)90995-4. [DOI] [PubMed] [Google Scholar]
  14. Krieger G., Wander H. E., Prangen M., Bandlow G., Beyer J. H., Nagel G. A. Bestimmung des carcinoembryonalen Antigens (CEA) zur Voraussage des Therapieerfolges beim metastasierenden Mammakarzinom. Dtsch Med Wochenschr. 1983 Apr 22;108(16):610–614. doi: 10.1055/s-2008-1069606. [DOI] [PubMed] [Google Scholar]
  15. Lamerz R., Leonhardt A., Ehrhart H., von Lieven H. Serial carcinoembryonic antigen (CEA) determinations in the management of metastatic breast cancer. Oncodev Biol Med. 1980;1(2):123–135. [PubMed] [Google Scholar]
  16. Lange P. H., McIntire K. R., Waldmann T. A., Hakala T. R., Fraley E. E. Serum alpha fetoprotein and human chorionic gonadotropin in the diagnosis and management of nonseminomatous germ-cell testicular cancer. N Engl J Med. 1976 Nov 25;295(22):1237–1240. doi: 10.1056/NEJM197611252952207. [DOI] [PubMed] [Google Scholar]
  17. Lee Y. T. Serial tests of carcinoembryonic antigen in patients with breast cancer. Am J Clin Oncol. 1983 Jun;6(3):287–293. doi: 10.1097/00000421-198306000-00006. [DOI] [PubMed] [Google Scholar]
  18. Libshitz H. I., Hortobagyi G. N. Radiographic evaluation of therapeutic response in bony metastases of breast cancer. Skeletal Radiol. 1981;7(3):159–165. doi: 10.1007/BF00361858. [DOI] [PubMed] [Google Scholar]
  19. Nicholson R. I., Campbell F. C., Blamey R. W., Elston C. W., George D., Griffiths K. Steroid receptors in early breast cancer: value in prognosis. J Steroid Biochem. 1981 Dec;15:193–199. doi: 10.1016/0022-4731(81)90275-2. [DOI] [PubMed] [Google Scholar]
  20. O'Callaghan C., Franklin P., Elliott T. S., Deverill I., Richards N., Powell R. J. C reactive protein concentrations in neonates: determination by a latex enhanced immunoassay. J Clin Pathol. 1984 Sep;37(9):1027–1028. doi: 10.1136/jcp.37.9.1027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Schultz H., Sell A., Nørgaard-Pedersen B., Arends J. Serum alpha-fetoprotein and human chorionic gonadotropin as markers for the effect of postoperative radiation therapy and/or chemotherapy in testicular cancer. Cancer. 1978 Nov;42(5):2182–2186. doi: 10.1002/1097-0142(197811)42:5<2182::aid-cncr2820420515>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  22. Steward A. M., Nixon D., Zamcheck N., Aisenberg A. Carcinoembryonic antigen in breast cancer patients: serum levels and disease progress. Cancer. 1974 May;33(5):1246–1252. doi: 10.1002/1097-0142(197405)33:5<1246::aid-cncr2820330509>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  23. Tormey D. C., Waalkes T. P., Snyder J. J., Simon R. M. Biological markers in breast carcinoma. III. Clinical correlations with carcinoembryonic antigen. Cancer. 1977 Jun;39(6):2397–2404. doi: 10.1002/1097-0142(197706)39:6<2397::aid-cncr2820390614>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  24. Williams M. R., Todd J. H., Nicholson R. I., Elston C. W., Blamey R. W., Griffiths K. Survival patterns in hormone treated advanced breast cancer. Br J Surg. 1986 Sep;73(9):752–755. doi: 10.1002/bjs.1800730925. [DOI] [PubMed] [Google Scholar]
  25. Woo K. B., Waalkes T. P., Ahmann D. L., Tormey D. C., Gehrke C. W., Oliverio V. T. A quantitative approach to determining disease response during therapy using multiple biologic markers: application to carcinoma of the breast. Cancer. 1978 May;41(5):1685–1703. doi: 10.1002/1097-0142(197805)41:5<1685::aid-cncr2820410507>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]

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