Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

BACKGROUND: False elevation of tumor marker levels (TM) has been encountered in some postsurgical breast cancer patients. METHODS: We investigated 33 postsurgical breast cancer patients whose TM (CEA, CA15-3, NCC-ST-439, or BCA225) measured every 3 months, showed elevation 3 times in a row in a 6-month period, and in whom metastases were not detected at theend of the 6-month period. Nine patients developed recurrence within 36 months of the end of the 6-month period and 24 patients did not develop recurrence for more than 36 months after the end of the 6-month period. RESULTS: Seven patients who stopped treatment with oral 5-FU or its derivatives because of severe nausea and appetite loss did not develop recurrence. Normalization of TM (CEA, NCC-ST-439, or BCA225) manifested within 3 months of the interruption of the medication. Six patients who showed simultaneous increase in serum glutamic-pyruvic transaminase (sGPT) and TM (CEA or BCA225) in the initial 6months did not develop recurrence. Three of 6 patients did not take any anti-cancer drugs. Correlation coefficiencies of sGPT with CEA in 4 patients were 0.467, 0.569, 0.738, and 0.910 and those of sGPT with BCA225 in 3 patients were 0.663, 0.826, and 0.840. CONCLUSION: A false-positive increase in CEA, NCC-ST-439 or BCA225 might be caused by treatment with oral 5-FU or its derivatives. CEA or BCA225 elevates false-positively in patients with high sGPT levels.
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PMID:Tumor Marker Levels Elevate False-Positively in Postsurgical Breast Cancer Patients with High sGPT Levels or with Receiving Oral 5-FU or Its Derivatives. 1109 13

In breast cancer there is often overexpression of the breast cancer antigen CA15-3, the carcinoembryonic antigen (CEA) and the ovarian cancer antigen CA125, which makes them potential target antigens for immunotherapy. In this study, we used a multi-antigen vaccine, which included the following antigens: autologous breast cancer cells (AUTOC), allogeneic breast cancer MCF-7 cells (ALLOC), and the tumor associated antigens CA15-3, CEA and CA125, plus low doses of granulocyte/macrophage-colony-stimulating factor (GM-CSF) and interleukin 2 (IL-2). Forty-two breast cancer patients received weekly subcutaneous vaccination at the 1st, 2nd, 3rd, 7th, 11th and 15th weeks. Their lymphocyte proliferative responses to AUTOC, ALLOC, CA15-3, CEA and CA125 were tested in lymphocyte blastogenesis assays (LBA) before and after vaccination. The disease stage and serum CA15-3, CEA and CA125 concentrations were also determined pre- and post-vaccination. We found that the vaccine was safe, and the only major side effects were swelling at the site of injection, muscle pain, and weakness or fatigue. The vaccine induced a significant increase in post-vaccination lymphocyte proliferative responses to AUTOC, CA15-3, CEA and CA125 but not ALLOC, compared to pre-vaccination (p < 0.05, p < 0.01, p < 0.05, p < 0.01 and p > 0.05, respectively, a paired t Test). Computed tomography (CT), ultrasound or bone scan showed evidence of disease improvement in 2 (12%) patients after vaccination. Hepatic metastases were reduced in size and number and some actually disappeared one patient. Metastatic disease in the L5 vertebra and the skull decreased in size and some osteolytic sites completely healed in a second patient. In addition, 7 patients (44%) had stable disease and 7 patients (44%) had disease progression. We did not find vaccination significantly reduced serum tumor markers CA15-3, CEA and CA125 of these breast cancer patients. These results suggest that the vaccine mixture of autologous and allogeneic breast cancer cells and tumor associated antigens plus GM-CSF and IL-2 can be administered safely to breast cancer patients and there is evidence for improved immunity and clinical efficacy.
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PMID:Vaccination with a mixed vaccine of autogenous and allogeneic breast cancer cells and tumor associated antigens CA15-3, CEA and CA125--results in immune and clinical responses in breast cancer patients. 1115 21

A 50-year-old female underwent mastectomy for left breast cancer in June, 1991. She received tamoxifen for 36 months and tegafur for 30 months as adjuvant therapy. In November 1997, liver, lung and para-aortic lymph node recurrences were found, and we treated her six times with docetaxel 60 mg. After the chemotherapy, a complete response (CR) of all metastatic lesions was achieved and her serum CA15-3 level was decreased. Adverse reactions were grade 4 neutropenia, grade 2 alopecia, fever, and grade 1 edema. She received medroxyprogesterone acetate after the chemotherapy and has been well without re-growth of any metastases for over eight months.
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PMID:[A case of recurrent breast cancer successfully treated with docetaxel]. 1126 9

TPS and CA 15-3 have been applied for monitoring treatment in patients with advanced breast cancer and the relationship between the initial marker levels and the changes of the markers during chemotherapy has been established. Both markers have demonstrated high sensitivity for detecting visceral and bone metastases in the patients (90-95%) compared to soft tissues and locally advanced disease (45-50%). The marker combination, TPS and CA15-3, showed the highest sensitivity for detecting bone/visceral metastases (98%) and soft tissue/locally advanced metastases (75%). TPS showed a more frequent decrease in marker level (> 50%) compared to CA 15-3 as well as the highest correlation (68%) to the clinically confirmed events CR, PR compared to CA 15-3 (54%). In the subgroup of metastatic breast cancer patients, demonstrating increased marker levels (> 25%) during follow-up, TPS showed the highest correlation compared to the clinically confirmed progressive disease. In the subgroup of patients with clinically confirmed progression, contemporary measurements of the marker values resulted in correlation with the clinical findings in 78% for TPS and 58% for CA 15-3. TPS appears to be superior to CA 15-3 for follow-up of metastatic breast cancer patients. TPS and CA 15-3 marker increase preceded the clinical and/or radiological signs of distant metastases in most of the patients; 1.5 and 1.1 months, respectively. The time elapsed between tumor marker increase and clinically confirmed progression was very short, which is also related to the frequent follow-up visits for metastatic breast cancer patients receiving chemotherapy. TPS appears to indicate the changes in the disease state earlier than clinical criteria or than the established tumor burden markers. The simultaneous determination of TPS and CA 15-3 provided additive information in advanced breast cancer patients and might guide management decisions in the individual patients.
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PMID:Use of TPS and CA 15-3 assays for monitoring chemotherapy in metastatic breast cancer patients. 1132 74

The efficacy of CEA and CA15-3 tumor markers in monitoring breast cancer was evaluated in 1365 patients with either benign (n = 534) or malignant (n = 831) breast diseases. Thirty-nine breast cancer patients were monitored before and after neoadjuvant chemotherapy. Three hundred forty-nine patients were monitored during post-surgical follow-up for either a minimum of 5 years or until time of recurrence. Twenty-one patients with metastases were also monitored during chemotherapy. Elevated CA 15-3 and TPS levels were found in 28.6% and 30.0% of patients. CA 15-3 and TPS sensitivities rose to 71.9% and 66.3% in metastatic patients, respectively. The addition of TPS to CA 15-3 increased the sensitivity up to 44.4% in the overall population, and to 87.6% in patients with metastases. During post-surgical follow-up CA 15-3 was elevated in 65.7% and TPS in 61.3% of patients with recurrence. The combination of TPS and CA 15-3 increased the overall sensitivity by 12.7%. Longitudinal monitoring of metastatic patients undergoing chemotherapy demonstrated that, when positive, both CA 15-3 and TPS paralleled response to treatment. TPS monitoring may provide additional value when used in combination with CA15-3 during post-surgical follow-up of breast cancer patients.
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PMID:Serum tissue polypeptide specific antigen (TPS): a complementary tumor marker to CA 15-3 in the management of breast cancer. 1167 13

We report a 64-year-old woman who underwent mastectomy for stage II (T2N1M0) advanced breast cancer, in whom multiple spine metastases developed 18 months postoperatively. She received 6 cycles of CA (cyclophosphamide 500 mg/m2, ADM 50 mg/m2 3 wq) therapy and oral tamoxifen (20 mg/body) administration for adjuvant therapy. The multiple bone metastases of the spine were revealed by technetium bone scan. The level of serum tumor marker CA15-3 increased two times over the normal range 18 months after surgery. She also developed osteoporosis a few years later, so we selected high-dose toremifene administration (120 mg/body) as a second-line therapy. No adverse effects have occurred and bone metastases disappeared. Moreover, the tumor marker was also normalized 6 months after toremifene therapy started. It was shown that high-dose treatment of toremifene was useful for recurrent breast cancer with bone metastasis.
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PMID:[A case of breast cancer with multiple bone metastases demonstrating complete remission with high-dose toremifene therapy]. 1522 11

A 76-year-old woman was diagnosed with advanced breast cancer with bilateral multiple lung and pleural metastases in March 2003. Her CEA and CA15-3 level were 7.6 ng/ml and 98.3 U/l, respectively. However, she refused intensive chemotherapy and chose a hormonal monotherapy with exemestane instead. The patient then did not return to our department for about one year, during which time she continued to take the same medications. When she visited again, CEA and CA15-3 level were reduced to within the normal range, and her multiple lung and pleural metastases were found to have almost completely disappeared upon computed tomography. Exemestane is expected to be an effective agent for the treatment of hormonal receptor-positive postmenopausal woman with life-threatening advanced breast cancer.
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PMID:[A case of aged advanced breast cancer with multiple lung and pleural metastases responding to exemestane monotherapy]. 1550 49

Here, the structure, function, biological and pathological significance and clinical utility of the principal biomolecular markers of breast cancer is reviewed. Each marker was scored for clinical utility using a recently developed tumor marker utility grading system (TMUGS). Among the tissue markers, ERs and PRs are important prognostic/predictive factors and the only tissue markers routinely determined. ER cross-talks with other growth factors while co-regulatory factors enhance (co-activators) or decrease (co-repressors) its transcriptional activity. C-erbB-2 and Ki67/MIB-1 select for adjuvant chemotherapy a subgroup of lymph-node negative patients at a high risk of relapse. Monoclonal antibodies (trastuzumab, gefitinib, erlotinib and bevacizumab) targeting tissue markers and involved in tumor growth and metastasization (EGFR, C-erbB-2, VEGF) have been developed; they showed therapeutical single agent activity as well as potent synergy with chemotherapy agents in metastatic cancer. Among circulating markers, some are potentially useful in the early detection and monitoring of metastatic disease; nevertheless, none is routinely recommended. To suspect distant metastases, CEA-TPA-CA15.3 panel attained accuracy of about 90%. ECD HER2-neu, p53 and nucleophosmin antibodies seem suitable candidates for different associations. Preliminary observations suggest that an early detection with tumor markers and successive treatment of relapses significantly prolongs disease-free and overall survival in selected patients. In conclusion, biomolecular markers are improving understanding of biology and management of breast cancer.
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PMID:Biomolecular markers of breast cancer. 1636 59

In metastatic breast cancer tumour markers' increase predicts, by a few months (lead time) disease progression. In breast cancer patients with endocrine dependent metastatic disease, we reported a prolonged clinical benefit and overall survival when first line conventional antiestrogen hormone therapy was started at the lead time and also when an immunotherapy schedule was added to the same conventional hormone treatment. Thirty-two of these last patients were considered (group a). In 27 (group b) of these 32 patients who progressed during first line salvage hormone plus immunotherapy the lead time at the progression of metastatic disease during therapy was compared with that at the onset of metastases when the same patients were without treatment and with that of a control group (group c) who did not receive immunotherapy. At disease progression, CEA-TPA-CA15.3 sensitivity was 92.5% in the group b (studied patients) and 88.5% in the group c (controls). At the progression in the group b, CEA-TPA-CA15.3 lead time (m+/-sd, months) was significantly longer than in group c (12.1+/-12.9 vs 2.4+/-4.0) (P=0.000). Besides, in group b the lead time was significantly longer at the progression than at the metastatic onset (P=0.003) while in the group c the difference was near to significance (P=0.05). The CEA-TPA-CA15.3 tumour marker panel accurately predicted metastatic disease progression and immunotherapy significantly prolonged the CEA-TPA-CA15.3 lead time. This can be used for anticipating salvage treatment in these patients.
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PMID:Immunotherapy prolongs the serum CEA-TPA-CA15.3 lead time at the metastatic progression in endocrine-dependent breast cancer patients: a retrospective longitudinal study. 1824 81

In order to find out prognostic factors and treatment results in small cell lung cancer (SCLC), 40 patients diagnosed in one year period were prospectively analysed. Following history and physical examination, patients were grouped according to ECOG performance scale and underwent Chest X-ray and thoracic computerized tomography (CT). Complete blood count, biochemical analyses, tumor markers were taken. Abdominal USG or CT, bone scintigraphy, cranial CT or MRI and bone marrow biopsy were made for detection of metastases. Limited stage patients received chemotherapy and thoracic RT, whereas cases with extensive disease received chemotherapy. Nineteen cases had limited and 21 had extensive disease. When laboratory findings between 2 stages were compared, LDH, SGOT and GGT were significantly higher in extensive stage (p= 0.005, 0.015, 0.001, respectively). Overall median survival was 6 +/- 1 months, cumulative survival in 6 and 12 months were 39% and 20.72%, respectively. Median survival was 10 +/- 2 months in limited stage and 3 +/- 1 months in extensive stage, with a statististically significant difference. Univariate analyses showed that incresed LDH, CA15-3, GGT and SGOT levels, hipoproteinemia and poor performance scale were poor prognostic signs (p= 0.024, 0.032, 0.047, 0.013, 0.021 ve 0.013, respectively), however multivariate analyses revealed no significant difference. Other blood tests, pleural effusion, age, mediastinal lymph node metastases and weight loss had no prognostic effect. Stage was found to be progniostic factor with both univariate and multivariate analyses (p= 0.045).
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PMID:[Prognostic factors in small cell lung cancer]. 1833 Jul 51


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