Neoadjuvant chemotherapy in
breast cancer patients aims at preoperative reduction of
tumor volume for better resection results and prognosis. As not all patients respond to
neoadjuvant therapy, predictive
biomarkers are needed for more efficient individual management. In prospectively collected sera of 51 consecutive locally confined
breast cancer (LBC) patients receiving preoperative,
neoadjuvant chemotherapy, value level kinetics of soluble high mobility group box 1 (
HMGB1), soluble
receptor for advanced glycation end products (sRAGE) as well as the established
breast cancer biomarkers CA 15-3 and
carcinoembryonic antigen (CEA) were investigated and correlated with
therapy response objectified by pathological staging at surgery. In addition,
biomarkers were measured in sera of 30 healthy controls (HC), 13 patients with benign
breast diseases, and 28 metastatic
breast cancer (MBC) patients. Pretherapeutic levels of soluble
HMGB1 were decreased in MBC, while sRAGE was already decreased in LBC. In contrast, CA 15-3 and CEA were strongly elevated in MBC, but not in LBC. Combination of sRAGE and CA 15-3 enabled best discrimination of LBC from HC (AUC 78.2 %; sens 58 % at 95 % spec), while CA15-3 and CEA discriminated best between MBC and all controls (AUC 90.9 %; sens 70 % at 95 % spec). In LBC patients undergoing
neoadjuvant chemotherapy, nine patients achieved complete remission (CR), 29 achieved partial remission (PR), while 13 had no change of disease (NC). NC patients tended to have higher
HMGB1 and lower sRAGE levels before
therapy onset (p = 0.056 and p = 0.054), while CA 15-3 and CEA did not predict therapeutic outcome. Furthermore, kinetics of
HMGB1 during
therapy correlated with efficacy of the treatment (p = 0.053). Markers of immunogenic cell death are valuable for the diagnosis of MBC and early estimation of response to
neoadjuvant therapy in LBC patients.