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Minerva Chirurgica 2003 June;58(3):297-304

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Objective measurement of remission and progression in metastatic breast cancer by the use of serum tumour markers

Cheung K. L., Robertson F. R.

Measurement of remission and progression in metastatic breast cancer by the use of serum tumour markers is simple, objective, reproducible and cost effective. The most widely used markers are a MUC1 mucin (e.g. measured as CA15.3) and CEA. A combination of markers is more sensitive than using a single marker. When CA15.3, CEA and ESR are used as a panel of serum markers in monitoring therapeutic response, over 90% of patients are biochemically assessable. A biochemical index score comprising these three markers has been devised retrospectively, validated prospectively, in a single centre and in a multicentre study. Biochemical assessment by serum markers correlates with clinical/radiological (UICC) assessment and often pre-dates remission and progression shown by UICC criteria. It is also the only validated method in monitoring metastatic breast cancer with disease unassessable by UICC criteria (e.g. sclerotic bone metastases, irradiated lesions). Future studies should aim at incorporating new markers (e.g. serum c-erbB2, markers of bone metabolism) to tailor different clinical situations, and at exploiting the use of serum markers to direct systemic therapy.