"Tumour marker guided" salvage treatment prolongs survival of breast cancer patients: final report of a 7-year study.

Abstract

OBJECTIVES:

Randomised trials on breast cancer showed no significant benefit from post-operative follow-up with clinical and/or conventional radiological means. We hypothesised that carcinoembryonic antigen (CEA), tissue polipeptyde antigen (TPA), breast cancer associated antigen 115 D8/DF3 (CA15.3) tumour marker panel is sensitive enough for significantly anticipating salvage treatment and prolonging survival of relapsing breast cancer patients.

METHODS:

From October 1981 to May 1999, 68 (62%) of 109 patients with distant metastases were recruited. Thirty-six (53%) received salvage treatment at the time of significant increase in one or more components of CEA-TPA-CA15.3 tumour marker panel and negative instrumental examinations ("tumour marker guided" treatment) and 32 (47%) were treated only after radiological confirmation of metastases (conventional treatment). The prognostic factors of the two groups did not show any statistically significant difference.

RESULTS:

The time from one or more tumour marker increase to clear clinical and/or radiological signs of distant metastases (lead time) was significantly prolonged in the 36 patients with "tumour marker guided" treatment (17.3 +/- 13.1 vs. 2.9 +/- 2.9 months, P < 0.001, Wilcoxon test) as well as the survival curves from salvage therapy and from mastectomy (the proportion of survivors was: at 36 months from salvage therapy 28% vs. 9%, P = 0.0094; at 84 months from mastectomy 42% vs. 19%, P = 0.0017). The multivariate Cox analysis showed that time from mastectomy to tumour marker increase and "tumour marker guided" salvage treatment were the only significantly different variables (P = 0.00001 and 0.005, respectively).

CONCLUSION:

These data point out that "tumour marker guided" salvage treatment significantly prolongs disease-free and overall survivals of relapsing responsive patients.

• Authors: Andrea Nicolini, Angelo Carpi, Claudio Michelassi, Claudio Spinelli, Massimo Conte, Paolo Miccoli, M Fini, R Giardino
• Journal: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (Biomed Pharmacother) Vol. 57 Issue 10 Pg. 452-9 (Dec 2003) ISSN: 0753-3322 [Print] France
• PMID: 14637388 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Biomarkers, Tumor
• Carcinoembryonic Antigen
• Mucin-1
• Peptides
• tissue polypeptide specific antigen

Topics

• Biomarkers, Tumor (blood)
• Breast Neoplasms (mortality, pathology, therapy)
• Carcinoembryonic Antigen (blood)
• Female
• Humans
• Middle Aged
• Mucin-1 (blood)
• Neoplasm Metastasis
• Peptides (blood)
• Salvage Therapy (mortality)