RESUMEN
Soluble Fas (sFas) and cytokeratin 18-Asp396 neoepitope (CK18-NE) were measured by ELISA in serial samples from 42 patients with different cancers under chemotherapy and were compared with pharmacokinetic results. Baseline sFas (median 6146 pg/ml, range 3123-16294 pg/ml) was higher in cancer patients than in normal subjects (median 4954 pglml, range 2595-10565 pg/ml, n =95) (p <0.01) and increased with the number of previous chemotherapy lines (p =0.008). During pharmacokinetics, the median sFas response differed significantly with tumour histology (p<0.001) and was correlated to 5-Fluorouracil (rho=0.366, p=0.015, n=45) or cisplatin (rho=0.509, p=0.025, n=21) concentrations but not to anthracyclines or oxazaphosphorine. By Kaplan-Meier analysis, patients with baseline sFas <6146 pg/ml had a longer survival probability (p=0.002). The median baseline CK18-NE did not differ from normal subjects, but its maximum increase differed according to histology (p=0.007) and to drug type (p=0.028). Patients with a maximum increase >67.5% (median) during chemotherapy had a better univariate overall survival (p=0.021). As measured by sFas concentration, chemotherapy induces an anti-apoptotic response of differing intensity according to tumour types and drugs, which has a prognostic value for survival. A CK18-NE elevation, indicative of chemotherapy-induced apoptosis, is linked to good prognosis.
Asunto(s)
Queratinas/sangre , Neoplasias/sangre , Neoplasias/tratamiento farmacológico , Receptor fas/sangre , Protocolos de Quimioterapia Combinada Antineoplásica/farmacocinética , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Cisplatino/farmacocinética , Doxorrubicina/farmacocinética , Ensayo de Inmunoadsorción Enzimática , Epítopos/sangre , Epítopos/inmunología , Femenino , Fluorouracilo/sangre , Fluorouracilo/farmacocinética , Humanos , Ifosfamida/farmacocinética , Queratinas/inmunología , Masculino , Neoplasias/inmunología , Proyectos PilotoRESUMEN
BACKGROUND: To evaluate longitudinal variations of serum HER-2/neu extracellular domain (sHER-2) in metastatic breast cancer patients receiving combined trastuzumab treatment. PATIENTS AND METHODS: Thirty-three patients were monitored by serial sHER-2 ELISA (Oncogene Science). Results were compared to time to progression (TTP) and survival from treatment initiation. Non parametric statistical tests were used. RESULTS: Median sHER-2 before first injection was 41.37 ng/ml (range 7.54-1597.00 ng/ml, n=32). Mean sHER-2 levels differed significantly between responders (n=20) and non responders (n=13) (p<0.0001). Median TTP (266 days, range 35-1000 days) was unrelated to clinico-biological variables at diagnosis or number and site of metastases before treatment. Patients with pre-treatment sHER-2 levels < or = 30 ng/ml (n=14) had a significantly longer TTP than the group with sHER-2 > 30 ng/ml (n=18) (p=0.0346) and sHER-2 levels were of prognostic value for overall survival from first injection (p=0.0150). CONCLUSION: Our results show that monitoring serum HER-2/neu levels during metastatic breast cancer can provide a real time assessment of a woman's HER-2/neu status and can provide important information for therapeutic decisions.
Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos/uso terapéutico , Neoplasias de la Mama/sangre , Neoplasias de la Mama/tratamiento farmacológico , Receptor ErbB-2/sangre , Adulto , Anticuerpos Monoclonales Humanizados , Antígeno Carcinoembrionario/sangre , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Femenino , Humanos , Persona de Mediana Edad , Mucina-1/sangre , TrastuzumabRESUMEN
BACKGROUND: The prognostic value of uPA, PAI-1 and PAI-2 mRNA expression was studied in a retrospective series of 130 primary breast cancer patients (median follow-up 8.1 years). MATERIALS AND METHODS: UPA, PAI-1 and PAI-2 mRNA were quantified by means of real-time quantitative RT-PCR. Comparison with the corresponding protein levels determined by ELISA was performed in 21 cases. RESULTS: Higher uPA protein values were found in cases with high mRNA values, but the relationship was of borderline significance. PAI-1 and PAI-2 mRNA were positively correlated to protein values. The mRNA expression of uPA, PAI-1 and PAI-2 was significantly correlated with one another. Higher uPA and PAI-1 mRNA values were significantly associated with shorter disease-free survival (DFS) (p = 0.002; p = 0.03, respectively). Low and very high PAI-2 mRNA values tended to be associated with longer DFS. In Cox multivariate analyses, higher uPA and PAI-1 mRNA values were independently associated with shorter DFS. PAI-2 was not retained as a significant variable in the Cox model. CONCLUSION: These preliminary results indicate that, in breast cancer, uPA, PAI-1 and PAI-2 mRNA analysis by quantitative RT-PCR give results comparable to those obtained at the protein level.