Relationship between preoperative serum CA 15-3 and CEA levels and clinicopathological parameters in breast cancer

Development and validation of a nomogram to predict Chinese breast cancer risk based on clinical serum biomarkers

Background: This study investigated and compared clinical serum biomarkers and developed a diagnostic nomogram for breast cancer. Methods: A total of 1224 breast cancer and 1280 healthy controls were enrolled. Univariate and multivariate analyses were performed to identify factors and a nomogram was developed. Discrimination, accuracy and clinical utility values were evaluated by receiver operating characteristic, Hosmer-Lemeshow, calibration plots, decision curve analysis and clinical impact plots. Results: carcinoembryonic antigen, CA125, CA153, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, fibrinogen and platelet distributing width were effectively identified to predict breast cancer. The nomogram showed the area under the curve of 0.708 and 0.710 in the training and validation set. Calibration plots, Hosmer-Lemeshow, decision curve analysis and clinical impact plots confirmed great accuracy and clinical utility. Conclusion: We developed and validated a nomogram that is effectively used for risk prediction of Chinese breast cancer.

Diagnostic impact of CEA and CA 15-3 on monitoring chemotherapy of breast cancer patients

Objective: Serum tumor markers has been evolved as an effective tool to determine prognosis and treatment efficiency in different types of cancer. The aim of this study was to explore the chemotherapy monitoring efficiency and prognostic sensitivity of tumor associated cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA) markers in early (II) and late (IV) clinical stages of breast cancer patients.   Methods: CA 15-3 and CEA serum levels were assessed in 56 breast cancer patients at early II (n = 26) and late IV (n = 30) clinical stages with primary inclusion criteria: who received adjuvant chemotherapy AC (Adriamycin & Cyclophosphamide) or AC-T (Adriamycin & Cyclophosphamide followed by Taxane) regimes and human epidermal growth factor receptor 2 (HER2) negative by using particle enhanced turbid metric assay.   Results: Higher elevation of CA 15-3 as compared to CEA in pre-treatment group of breast cancer patients as compared to healthy control was observed. Late-stage patients showed higher positive serum levels as compared to early-stage one for both markers with preference of CA 15-3 over CEA. AC-T chemotherapy regime treatment in both clinical stages revealed significantly higher level of both markers as compared to AC regime with preference of CA 15-3 over CEA at late stage. Both markers levels were significantly higher in late-stage group as compared with early-stage ones for both chemotherapy regimens.   Conclusion: CA 15-3 is more efficient as prognostic monitoring marker in comparison with CEA and revels a positive connection between chemotherapy regime system and staging, more observed in late-stage.  

The Novel Diagnostic Techniques and Biomarkers of Canine Mammary Tumors

Canine mammary tumors (CMTs) are considered a serious clinical problem in older bitches. Due to the high malignancy rate and poor prognosis, an early diagnosis is essential. This article is a summary of novel diagnostic techniques as well as the main biomarkers of CMTs. So far, CMTs are detected only when changes in mammary glands are clinically visible and surgical removal of the mass is the only recommended treatment. Proper diagnostics of CMT is especially important as they represent a very diverse group of tumors and therefore different treatment approaches may be required. Recently, new diagnostic options appeared, like a new cytological grading system of CMTs or B-mode ultrasound, the Doppler technique, contrast-enhanced ultrasound, and real-time elastography, which may be useful in pre-surgical evaluation. However, in order to detect malignancies before macroscopic changes are visible, evaluation of serum and tissue biomarkers should be considered. Among them, we distinguish markers of the cell cycle, proliferation, apoptosis, metastatic potential and prognosis, hormone receptors, inflammatory and more recent: metabolomic, gene expression, miRNA, and transcriptome sequencing markers. The use of a couple of the above-mentioned markers together seems to be the most useful for the early diagnosis of neoplastic diseases as well as to evaluate response to treatment, presence of tumor progression, or further prognosis. Molecular aspects of tumors seem to be crucial for proper understanding of tumorigenesis and the application of individual treatment options.

The impact of different preanalytical methods related to CA 15-3 determination in frozen human blood samples: a systematic review

BACKGROUND

The determination of CA 15-3 is useful for monitoring breast cancer patients. Several retrospective studies determined CA 15-3 levels in frozen samples to evaluate the sensitivity and specificity of novel biomarkers in relation to breast cancer; however, freeze-thaw cycles, as well as preanalytical variables before sample storage, are not always reported. Here, we analyzed the current scientific literature to identify possible critical aspects related to CA 15-3 determination in frozen-stored human serum/plasma samples.

METHODS

We obtained data from 4 different bibliographic databases: Web of Science, Embase, PubMed, and Cochrane Library. We followed the PRISMA guidelines to screen and select the eligible articles discussed in the final revision.

RESULTS

Initially, 674 scientific papers were evaluated, and after the application of the screening and eligibility criteria, 18 studies were included in the qualitative synthesis. The analysis reported an important level of heterogeneity concerning the preanalytical phase before sample storage.

CONCLUSION

Although advances in healthcare have been achieved using certified workflows in medical diagnostics, standardized preanalytical processes are not always applied when referring to frozen-stored biosamples. Biobanks will guarantee the best possible conditions for the storage of human biological samples to be used in clinical research. The use of certified bioresources will favor the optimal development and introduction of new disease biomarkers.

CEA, CA 15-3, and miRNA expression as potential biomarkers in canine mammary tumors

The most often detected tumor in intact bitches is mammary tumors and represents a significant clinical problem throughout the world. Mammary neoplasms in canine have heterogeneous morphology, so the choice of the most appropriate biomarker is the biggest challenge in CMT detection. We performed a retrospective analysis and evaluated the canine cancer antigens and miRNA expression profiles as potential biomarkers. Sixty dogs based on histological examination divided into three groups, viz., dogs with a benign mammary tumor, malignant mammary tumor, and control/healthy. The CA 15-3 was found more sensitive than CEA but detection of both will increase sensitivity. miR-21 expression differed significantly in all three groups. miR-29b expression differed significantly between the control and benign group and control and malignant group. The miR-21 overexpression and miR-29b downregulation with CMT are associated with clinical stage and can be used as non-invasive diagnostic and prognostic biomarkers. Hence, evaluation of CA 15-3 along with CEA would be a non-invasive technique for detecting canine mammary tumors. Evaluation of deregulated circulating miR-21 could be a valuable prognostic marker for early detection of mammary tumors in canines while miR-29b can add sensitivity in the detection of the canine mammary tumors if evaluated with miR-21.

Comparative Study of Blood, Tissue and Serum Levels of Carcinoembryonic Antigen (CEA) Detection in Breast Cancer

Background:

Carcinoembryonic antigen (CEA) detection was evaluated in breast cancer (BC). The statistical correlation between the CEA mRNA and clinico-pathological features in the peripheral blood (PB) and tissue samples of BC was assessed.

Materials and Methods:

RT-PCR (Reverse transcription-polymerase chain reaction) analysis was applied to study the expression of CEA in PB of 30 healthy females and 30 patients with operable BC before receiving any therapy, as well as in the tissue of 30 BC patients.

Results:

CEA was observed in a number of normal subjects, but there was a significant difference between the patients and controls. The detected CEA mRNA from tissue samples were the same as PB of patients and a correlation was observed between the CEA mRNA in PB and tissue samples (Pearson chi-square = 8.62, P=0.003). In the PB, CEA mRNA was significantly different in HER-2 (-)/HR (+) compare with HER-2(+)/HR (-) tumor group (p=0.026). Finally, CEA in serum was also significantly different in HER-2(-)/HR (+) compared with HER-2(+)/HR (+) and HER-2(+)/HR (-) subtypes (p=0.008 and p=0.043, respectively).

Conclusion:

CEA mRNA evaluation is diagnostically valuable as a breast cancer marker. Additionally, CEA can significantly improve the sensitivity of diagnosis.

Genetic and molecular biology of breast cancer among Iranian patients

Abstract

Background, Breast cancer (BC) is one of the leading causes of cancer related deaths in Iran. This high ratio of mortality had a rising trend during the recent years which is probably associated with late diagnosis.

Main body

Therefore it is critical to define a unique panel of genetic markers for the early detection among our population. In present review we summarized all of the reported significant genetic markers among Iranian BC patients for the first time, which are categorized based on their cellular functions.

Conclusions

This review paves the way of introducing a unique ethnic specific panel of diagnostic markers among Iranian BC patients. Indeed, this review can also clarify the genetic and molecular bases of BC progression among Iranians.

Vitamin B12 and folic acid associated megaloblastic anemia: Could it mislead the diagnosis of breast cancer?

CA 15-3 is a tumor-associated antigen and is overexpressed in breast tumors, and may also be high in some other non-cancerous conditions. The aim of this study was to investigate the effect of megaloblastic anemia due to vitamin B12 or folic acid deficiency on the levels of tumor markers. Five-year patient data were retrospectively analyzed. The associations between megaloblastic anemia due to vitamin B12 deficiency and CA 15-3, CA 125, CA 19-9, CEA, and AFP levels were analyzed. Furthermore, association between CA 15-3 level and megaloblastic anemia due to folic acid deficiency was evaluated. Median CA 15-3 level was 38.1 U/mL in the group with megaloblastic anemia due to vitamin B12 deficiency(n = 15), 46.7 U/mL in the group with megaloblastic anemia related to folic acid deficiency (n = 3), and 17.8 U/mL in the normal group(n = 1724). CA 15-3 levels were significantly higher among patients with vitamin B12- and folic acid-associated megaloblastic anemia compared to the normal group (p = 0.001 and p = 0.005, respectively). Megaloblastic anemia due to vitamin B12 deficiency was not associated with any significant differences in CA 125, CA 19-9, CEA, or AFP levels compared to the normal group (p = 0.777, p = 0.327, p = 0.577, and p = 0.197, respectively). The numbers of anemic and normal subjects compared in these tests were 12 vs. 1501, 17 vs. 1827, 4 vs. 897, and 8 vs. 1041, respectively. In conclusion, megaloblastic anemia results in ineffective erythropoiesis, and increased levels of CA 15-3 may be associated with this issue. Clinicians should take this into account when evaluating for a pre-diagnosis of breast cancer.

Comparison of breast cancer risk factors among molecular subtypes: A case-only study

Epidemiological studies have a clear definition of the risk factors for breast cancer. However, it is unknown whether the distribution of these factors differs among breast cancer subtypes. We conducted a hospital‐based case‐only study consisting of 8067 breast cancer patients basing on the Tianjin Cohort of Breast Cancer Cases. Major breast cancer subtypes including luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)‐enriched and basal‐like were defined by estrogen receptor, progesterone receptor, HER2, and Ki‐67 status. Variables including demographic characteristics, reproductive factors, lifestyle habits, imaging examination, and clinicopathologic data were collected for patients. Chi‐square test and one‐way analysis of variance were used to compare the distributions of variables among the four breast cancer subtypes. Multivariate logistic regression was used to estimate the odds ratios and associated 95% confidence intervals where luminal A patients served as the reference group. Overall, more commonality rather than heterogeneity on the distributions of factors was found between the four molecular subtypes of breast cancer. The proportion of overweight and obesity were lower in HER2‐enriched subtype. Women with age at menarche ≤13 years were more likely to be found in basal‐like subtype. Postmenopausal women were more frequent in HER2‐enriched and basal‐like subtypes. Women with benign breast disease and higher breast density were more common in HER2‐enriched subtype. Risk factor scoring showed that total risk scores were similar among the four subtypes. HER2‐enriched and basal‐like subtypes were more frequently diagnosed with large tumors. Calcification was more likely to be found in luminal B and HER2‐enriched subtypes, whereas less distributed in basal‐like subtype. Most of the breast cancer risk factors were similarly distributed among the four major breast cancer subtypes; commonality is predominant.

Current biomarkers of canine mammary tumors

Mammary tumors are the second most common neoplasia in dogs. Due to the high similarity of canine mammary tumors (CMT) to human breast cancers (HBC), human biomarkers of HBC are also detectable in cases of CMT. The evaluation of biomarkers enables clinical diagnoses, treatment options and prognosis for bitches suffering from this disease. The aim of this article is to give a short summary of the biomarkers of CMT based on current literature. Very promising biomarkers are miRNAs, cancer stem cells, and circulating tumor cells, as well as mutations of the breast cancer 1 gene (BRCA1) and breast cancer 2 gene (BRCA2). Until now, the most studied and reliable biomarkers of CMT have remained antigen Ki-67 (Ki-67), endothelial growth factor receptor, human epidermal growth factor receptor 2 (HER-2), estrogen receptor, progesterone receptor and cyclooxygenase 1 (COX-2), which can be detected in both serum and tissue samples using different molecular methods. However, carcinoembryonic antigen and cancer antigen 15-3 (CA 15-3), while poorly studied, seem to be good biomarkers, especially for the early detection and prognosis of CMT. We will also mention the following: proliferative cell nuclear antigen, tumor protein p53 (p53), E-cadherin, vascular endothelial growth factor, microRNAs, cancer stem cells and circulating tumor cells, which can also be useful biomarkers. Although many studies have been conducted so far, the estimation of biomarkers in cases of CMT is still not a common practice, and more detailed research should be done.

Predicting the response to neoadjuvant therapy for early-stage breast cancer: tumor-, blood-, and imaging-related biomarkers

Neoadjuvant therapy (NAT) has been used increasingly in patients with locally advanced or early-stage breast cancer. However, the accurate evaluation and prediction of response to NAT remain the great challenge. Biomarkers could prove useful to identify responders or nonresponders, or even to distinguish between early and delayed responses. These biomarkers could include markers from the tumor itself, such as versatile proteins, genes, and ribonucleic acids, various biological factors or peripheral blood cells, and clinical and pathological features. Possible predictive markers could also include multiple features from functional imaging, such as standard uptake values in positron emission tomography, apparent diffusion coefficient in magnetic resonance, or radiomics imaging biomarkers. In addition, cells that indirectly present the immune status of tumor cells and/or their host could also potentially be used as biomarkers, eg, tumor-infiltrating lymphocytes, tumor-associated macrophages, and myeloid-derived suppressor cells. Though numerous biomarkers have been widely investigated, only estrogen and/or progesterone receptors and human epidermal growth factor receptor have been proven to be reliable biomarkers to predict the response to NAT. They are the only biomarkers recommended in several international guidelines. The other aforementioned biomarkers warrant further validation studies. Some multigene profiling assays that are commercially available, eg, Oncotype DX and MammaPrint, should be used with caution when extrapolated to NAT settings. A panel of combined multilevel biomarkers might be able to predict the response to NAT more robustly than individual biomarkers. To establish such a panel and its prediction model, reliable methods and extensive clinical validation are warranted.

Modulation of Molecular Biomarker Expression in Response to Chemotherapy in Invasive Ductal Carcinoma

Breast cancer (BC) has varied morphological and biological features and is classified based on molecular and morphological examinations. Molecular classification of BC is based on biological gene-expression profiling. In this study, biomarker modulation was assessed during BC treatment in 30 previously untreated patients. Heterogeneity among patients was pathologically diagnosed and classified into luminal and basal-like immunohistochemical profiles based on estrogen, progesterone, and human epidermal growth factor receptor (ER/PR/HER2) status. Marker heterogeneity was compared with mRNA biomarker expression in patients with BC before and after therapy. Reverse transcription-polymerase chain reaction was performed for molecular characterization. Expression and modulation of biological markers, CK19, hMAM, CEA, MUC, Myc, Ki-67, HER2/neu, ErbB2, and ER, were assessed after treatment, where the expression of the biomarkers CK19, Ki-67, Myc, and CEA was noted to be significantly decreased. Marker expression modulation was determined according to different stages and pathological characteristics of patients; coexpression of three markers (CK19, Ki-67, and Myc) was specifically modulated after therapy. In the histopathologically classified basal-like group, two markers (CK19 and Ki-67) were downregulated and could be considered as diagnostic biomarkers. In conclusion, pathological characteristics and marker variation levels can be evaluated to decide a personalized treatment for patients.

Analysis of blood markers for early breast cancer diagnosis

PURPOSE

Breast cancer is the most common neoplasm in women and has the highest associated mortality rate. Rapid detection programmes can provide early diagnosis and increase the chances of survival. There are no specific tumor biomarkers for the early phase of the disease. The primary aim of this study was to search a blood biomarker with levels that exceeded the normal range established in the general population that could be used to screen breast cancer.

METHODS/PATIENTS

Case-control study. Conventional as well as research (NGAL, EGFR and 8-OHdG) tumor biomarkers were analyzed.

RESULTS

A total of 126 women were enrolled (cases: 63 patients with local breast cancer; Controls: 63 healthy women). Significant differences were found in patients with higher levels of the conventional markers, Ca15.3, CEA, Cyfra 21.1 and NSE. However, when commercial cut-off values were used, only Ca 15.13 was significant. In the group of research biomarkers, significantly higher levels of EGFR were found in the control group, and of 8-OHdG in the case group. Using logistic regression analysis and a ROC curve, an equation composed of five markers, Ca 15.3, NSE, NGAL, EGFR and 8-OHdG, which yielded a correct diagnostic probability of breast cancer of 91.8% was obtained.

CONCLUSIONS

8-OHdG has been identified as a new potential marker for screening early stage breast cancer. In addition, a model that combines five blood markers that can be used as a diagnostic test in certain groups of patients has been developed. New studies with a larger sample size are needed to verify the results obtained.

Serum CA125 is a predictive marker for breast cancer outcomes and correlates with molecular subtypes

Detection of serum tumor markers has been developed as a non-invasive tool to assess treatment efficiency in different types of cancer. This study aims to investigate the role of preoperative serum tumor markers (CEA, CA125 and CA15-3) in the management of breast cancer, and their relationships with patients’ clinicopathological parameters as well as different molecular subtypes. Altogether, 151 patients with invasive breast cancer and 180 control subjects with benign breast diseases were enrolled in this study. In the present study, preoperative serum levels of CEA, CA125 and CA15-3 were significantly higher in patients with breast cancer than controls subjects. Moreover, late-stage cancer patients exhibited significantly higher levels of CEA, CA125 and CA15-3 compared with early-stage ones. Statistical analysis indicated that elevated CA125 and CA15-3 levels were obviously related to patients with larger tumor diameter (>5cm) and lymph node metastasis. Furthermore, our results showed that the preoperative serum levels of CA125 exhibited statistical differences among various molecular subtypes, with the most frequent elevations occurring in the triple-negative tumors. In summary, our study indicated that the preoperative serum levels of CEA, CA125 and CA15-3 might be more efficient for monitoring advanced tumors than early diagnosis. High preoperative CA125 levels may reflect tumor burden and are associated with aggressive molecular subtype, suggesting that it can be used to predict poor outcome and prognosis of breast cancer patients.

A Noninvasive Blood-based Combinatorial Proteomic Biomarker Assay to Detect Breast Cancer in Women Under the Age of 50 Years

BACKGROUND

Despite significant advances in breast imaging, the ability to detect breast cancer (BC) remains a challenge. To address the unmet needs of the current BC detection paradigm, 2 prospective clinical trials were conducted to develop a blood-based combinatorial proteomic biomarker assay (Videssa Breast) to accurately detect BC and reduce false positives (FPs) from suspicious imaging findings.

PATIENTS AND METHODS

Provista-001 and Provista-002 (cohort one) enrolled Breast Imaging Reporting and Data System 3 or 4 women aged under 50 years. Serum was evaluated for 11 serum protein biomarkers and 33 tumor-associated autoantibodies. Individual biomarker expression, demographics, and clinical characteristics data from Provista-001 were combined to develop a logistic regression model to detect BC. The performance was tested using Provista-002 cohort one (validation set).

RESULTS

The training model had a sensitivity and specificity of 92.3% and 85.3% (BC prevalence, 7.7%), respectively. In the validation set (BC prevalence, 2.9%), the sensitivity and specificity were 66.7% and 81.5%, respectively. The negative predictive value was high in both sets (99.3% and 98.8%, respectively). Videssa Breast performance in the combined training and validation set was 99.1% negative predictive value, 87.5% sensitivity, 83.8% specificity, and 25.2% positive predictive value (BC prevalence, 5.87%). Overall, imaging resulted in 341 participants receiving follow-up procedures to detect 30 cancers (90.6% FP rate). Videssa Breast would have recommended 111 participants for follow-up, a 67% reduction in FPs (P < .00001).

CONCLUSIONS

Videssa Breast can effectively detect BC when used in conjunction with imaging and can substantially reduce unnecessary medical procedures, as well as provide assurance to women that they likely do not have BC.

Binding of circulating anti-MUC1 antibody and serum MUC1 antigen in stage IV breast cancer

The present study aimed to investigate the binding of circulating mucin 1 (MUC1) antibody with serum MUC1 antigen in stage IV breast cancer. Serum samples of 61 patients with stage IV breast cancer and 64 patients with early-stage breast cancer were collected. The anti‑MUC1 antibody (IgG) and MUC1 antigen (cancer antigen 15‑3; Ca15‑3) were detected using an indirect enzyme-linked immunosorbent assay (I‑ELISA) and ELISA, respectively. The MUC1 IgG affinity was detected using a urea degradation combining ELISA. Western blot analysis and an inhibition test were performed for verification of the binding of anti‑MUC1 IgG with MUC1 antigen, and their correlation was analyzed. The results showed that there was a negative correlation between anti‑MUC1 IgG and CA15‑3 antigen in stage IV breast cancer when positive CA15‑3 antigen and/or anti‑MUC1 IgG were selected (r=‑0.417; P=0.0044). The positive anti‑MUC1 IgG with positive Ca15‑3 antigen was more common in stage IV breast cancer, compared with early‑stage breast cancer (χ2=4.629; P=0.031), however, Ca15‑3 antigen positivity was higher in stage IV breast cancer, compared with early‑stage breast cancer (χ2=10.58; P=0.001). Anti‑MUC1 IgG was able to bind to the MUC1 antigen in stage IV breast cancer. No differences in the 8R-MUCPT inhibition ratio were found between the two groups (P=0.778), and there were no differences in the affinity of anti‑MUC1 IgG (P=0.873). In stage IV breast cancer, circulating anti‑MUC1 antibody was found to bind serum MUC1 antigen, although their compatibility was low. No significant difference was found in the affinity of the anti‑MUC1 antibody between stage IV breast cancer and early‑stage breast cancer.

Assessing Clinical Significance of Serum CA15-3 and Carcinoembryonic Antigen (CEA) Levels in Breast Cancer Patients: A Meta-Analysis

Background

Breast cancer is the most common malignant cancer in women worldwide. The tumor markers Cancer Antigen 15-3 (CA15-3) and Carcinoembryonic Antigen (CEA) are frequently used for screening and monitoring breast cancer.

Material/Methods

We conducted a meta-analysis of 13 published case-control studies to assess the associations between serum levels of CA15-3 and CEA with breast cancer susceptibility, including 1179 cases and 493 controls. The analyses were performed on malignant tumor and benign tumor, as well as in different subgroups with respect to the patient ethnicities and clinical tumor stages.

Results

This systematic review and meta-analysis of association studies shows that serum levels of CA15-3 and CEA are potential biomarkers for breast cancer monitoring. When stratified by clinical stage, we noticed that although malignant tumors in all stages show elevated levels of CA15-3, it is greatly associated with the tumor stage, as it increases as breast tumor stage worsens.

Conclusions

This study clarifies the inconsistent conclusions from multiple studies, and provides a precise estimation for clinical utility of 2 important biomarkers, CA15-3 and CEA, in breast cancer monitoring. Thus, our study will shed lights on the prognosis of breast cancer patients.

Efficient Molecular Imprinting Strategy for Quantitative Targeted Proteomics of Human Transferrin Receptor in Depleted Human Serum

Soluble transferrin receptor (sTfR) in serum has been suggested as a marker for breast cancer diagnosis, monitoring and treatment. However, sTfR levels in some situations could be far below the limit of quantification (LOQ) of most assays. Thus, an efficient sample pretreatment strategy is required. In this study, molecularly imprinted polymers (MIPs) were developed and coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based targeted proteomics for sTfR measurement. The key to this effort was that the same surrogate peptide of sTfR (VEYHFLSPYVSPK, VK13) was employed in both the enrichment by MIPs and the quantification by targeted proteomics. Specifically, three peptide templates with different lengths were evaluated for the synthesis of MIPs, and the imprinting conditions were optimized. The characteristics of MIPs, including the adsorption capacity, adsorption kinetics, and binding selectivity, were also investigated. As a result, a ∼12-fold enhancement of sensitivity was achieved using MIPs. An LOQ of 200 ng·mL(-1) was obtained. The intra- and interday precision were <10.7 and 7.8%, respectively. The accuracy was 7.5% at the lower limit of quantification (LLOQ) and <8.4% for the other QC levels. After validation, the assay was applied to determine the sTfR levels in breast cancer patients (n = 20) and healthy volunteers (n = 20) using the standard addition method. The corresponding levels of sTfR were 1.59 ± 0.36 μg·mL(-1) (range: 0.96-2.34 μg·mL(-1)) in the volunteers and 1.82 ± 0.42 μg·mL(-1) (range: 0.95-2.47 μg·mL(-1)) in the patients. This study is among the first to combine MIPs and LC-MS/MS targeted proteomics for protein quantification at the peptide level.

A systemic analysis on pemetrexed in treating patients with breast cancer

BACKGROUND

This systemic analysis was conducted to evaluate the efficacy and safety of pemetrexed based chemotherapy in treating patients with metastatic breast cancer as first or second line chemotherapy.

METHODS

Clinical studies evaluating the efficacy and safety of pemetrexed based regimens on response and safety for patients with breast cancer were identified using a predefined search strategy. Pooled response rate (RR) of treatment were calculated.

RESULTS

In first line pemetrexed based regimens, 10 clinical studies which including 513 patients with advanced breast cancer were considered eligible for inclusion. For second line pemetrexed based chemotherapy, 5 clinical studies which including 281 patients with advanced breast cancer were considered eligible. Systemic analysis suggested that, in all patients, pooled RR was 32.6% (167/513) in pemetrexed based first line regimens, and 13.9 % (39/281) in pemetrexed based second line regimens. Major adverse effects were neutropenia, leukopenia, fatigue, and anemia in pemetrexed based first line treatment; and lymphopenia, neutropenia, leukopenia, as well as anemia in second line chemotherapy. One treatment related death occurred with pemetrexed based second line treatment.

CONCLUSION

This systemic analysis suggests that pemetrexed based first line regimens are associated with a reasonable response rate and acceptable toxicity, however with low response rate for treating patients with metastatic breast cancer when is used in the second line.

Significant correlation between salivary and serum Ca 15-3 in healthy women and breast cancer patients

The tumor marker CA 15-3 is one of the most import reliable for metastatic breast cancer monitoring. While it is generally assessed in serum of patients, blood sampling is an invasive method compared to saliva sampling which is simple and could be an alternative to blood according to many studies. The aim of this investigation was to assess the relationship between serum and salivary concentrations of the protein CA 15-3 in patients with breast cancer and healthy asymptomatic volunteers. A case-control study was conducted with 60 women: 29 breast cancer patients from the Maternity Hospital Souissi Rabat (Morocco) and 31 healthy asymptomatic women. The CA 15-3 concentrations in saliva and serum samples were assessed using an enzyme immune assay (EIA kits) and comparison between cases and controls was made by the Mann-Whitney test. The correlation between serum and saliva CA 15-3 concentration was tested using Pearson correlation. The comparison result of CA15-3 concentration in saliva and serum level in cases and controls was not statistically significant (p>0.05). However, the correlation between salivary and serum CA 15-3 concentration was positive and statistically significant (r=0.27, p=0.03). In conclusion, the positive correlation between salivary and serum expression found in our study suggests that saliva could be an alternative to blood sampling to help breast cancer monitoring.