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Quantitation of response to therapy in patients with metastatic breast carcinoma by serial analysis of plasma gross cystic disease fluid protein and carcinoembryonic antigen
Author(s) -
Silva John S.,
Leight George S.,
Haagensen Darrow E.,
Tallos Peter B.,
Cox Edwin B.,
Dilley William G.,
Wells Samuel A.
Publication year - 1982
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19820315)49:6<1236::aid-cncr2820490627>3.0.co;2-t
Subject(s) - carcinoembryonic antigen , medicine , gastroenterology , predictive value , chemotherapy , carcinoma , oncology , endocrinology , cancer
The maximum percent change (MPC) of plasma carcinoembryonic antigen (CEA) and gross cystic disease fluid protein (CDP) were correlated with response to therapy in 92 metastatic breast carcinoma patients. In patients treated with hormone therapy MPC values were significantly different between patients with disease progression (Prog) and regression (Reg): MPC‐CEA for Reg = −72 ± 7%, for Prog = 396 ± 150%; MPC‐CDP for Reg = −86 ± 6%, for Prog = 702 ± 330%, P > 0.001 in a one‐way ANOVA for CEA and CDP. Similar differences were noted in patients treated with chemotherapy. Decreased (>50%) plasma CEA levels were observed in 24/29 (83%) of Reg, 18/35 (51%) stable and 0/49 (0%) of Prog; decreased (>50%) plasma CDP levels were noted in 19/24 (79%) of Reg, 21/28 (75%) of stable and 2/35 (6%) of Prog. Patients with plasma marker decreases > 50% had significantly longer responses to therapy (14.2 months for CEA, 14.1 months for CDP) compared to patients with < 20% decrease (2.0 months for CEA, 0.8 months for CDP), P < 0.001 in a one‐way ANOVA. Decreasing marker levels during the initial six weeks of therapy (negative slope) accurately identified Reg or stable patients: the predictive value of a negative slope was 92% for CEA and 86% for CDP. Rising marker values correctly identified treatment failures (Prog): the predictive value of a positive slope was 90% for CEA and 76% for CDP. These data indicated that changes in plasma CEA and CDP levels reflected increasing or decreasing tumor burden during hormone or chemotherapy treatment of metastatic breast carcinoma. Criteria have been established to predict therapeutic outcome based on the slope of CEA or CDP after six weeks of treatment.