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

Chemotherapy monitoring by serum markers

Authors

  • Diya Hasan Department of Allied Medical Sciences, Zarqa College, Al-Balqa Applied University, Zarqa - Jordan

DOI:

https://doi.org/10.33393/jcb.2022.2446

Keywords:

Breast cancer, CEA, CA 15-3, Chemotherapy, Prognosis

Abstract

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.

 

References

Abdel-Razeq H, Mansour A, Jaddan D. Breast cancer care in Jordan. JCO Glob Oncol. 2020;6(6):260-268. https://doi.org/10.1200/JGO.19.00279 PMID:32083950

Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92(3):205-216. https://doi.org/10.1093/jnci/92.3.205 PMID:10655437

Alunni-Fabbroni M, Müller V, Fehm T, Janni W, Rack B. Monitoring in metastatic breast cancer: is imaging outdated in the era of circulating tumor cells? Breast Care (Basel). 2014;9(1):16-21. https://doi.org/10.1159/000360438 PMID:24803882

Bidard FC, Hajage D, Bachelot T, et al. Assessment of circulating tumor cells and serum markers for progression-free survival prediction in metastatic breast cancer: a prospective observational study. Breast Cancer Res. 2012;14(1):R29. https://doi.org/10.1186/bcr3114PMID:22330883

Liu L, Xu HX, Wang WQ, et al. Serum CA125 is a novel predictive marker for pancreatic cancer metastasis and correlates with the metastasis-associated burden. Oncotarget. 2016;7(5):5943-5956. https://doi.org/10.18632/oncotarget.6819 PMID:26745601

Falzarano R, Viggiani V, Michienzi S, et al. Evaluation of a CLEIA automated assay system for the detection of a panel of tumor markers. Tumour Biol. 2013;34(5):3093-3100. https://doi.org/10.1007/s13277-013-0877-x PMID:23775009

Thompson JA, Grunert F, Zimmermann W. Carcinoembryonic antigen gene family: molecular biology and clinical perspectives. J Clin Lab Anal. 1991;5(5):344-366. https://doi.org/10.1002/jcla.1860050510 PMID:1941355

Molina R, Auge JM, Farrus B, et al. Prospective evaluation of carcinoembryonic antigen (CEA) and carbohydrate antigen 15.3 (CA 15.3) in patients with primary locoregional breast cancer. Clin Chem. 2010;56(7):1148-1157. https://doi.org/10.1373/clinchem.2009.135566 PMID:20472825

Uehara M, Kinoshita T, Hojo T, Akashi-Tanaka S, Iwamoto E, Fukutomi T. Long-term prognostic study of carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA 15-3) in breast cancer. Int J Clin Oncol. 2008;13(5):447-451. https://doi.org/10.1007/s10147-008-0773-3PMID:18946756

Dnistrian AM, Schwartz MK, Greenberg EJ, Smith CA, Schwartz DC. CA 15-3 and carcinoembryonic antigen in the clinical evaluation of breast cancer. Clin Chim Acta. 1991;200(2-3):81-93. https://doi.org/10.1016/0009-8981(91)90080-V PMID:1777973

Jezersek B, Cervek J, Rudolf Z, Novaković S. Clinical evaluation of potential usefulness of CEA, CA 15-3, and MCA in follow-up of breast cancer patients. Cancer Lett. 1996;110(1-2):137-144. https://doi.org/10.1016/S0304-3835(96)04473-4 PMID:9018092

Robertson JF, Jaeger W, Syzmendera JJ, et al; European Group for Serum Tumour Markers in Breast Cancer. The objective measurement of remission and progression in metastatic breast cancer by use of serum tumour markers. Eur J Cancer. 1999;35(1):47-53. https://doi.org/10.1016/S0959-8049(98)00297-4 PMID:10211087

Duffy MJ, Shering S, Sherry F, McDermott E, O’Higgins N. CA 15-3: a prognostic marker in breast cancer. Int J Biol Markers. 2000;15(4):330-333. https://doi.org/10.1177/172460080001500410 PMID:11192829

Kurebayashi J. [Biomarkers in breast cancer]. Gan To Kagaku Ryoho. 2004;31(7):1021-1026. PMID:15272579

Shering SG, Sherry F, McDermott EW, O’Higgins NJ, Duffy MJ. Preoperative CA 15-3 concentrations predict outcome of patients with breast carcinoma. Cancer. 1998;83(12):2521-2527. https://doi.org/10.1002/(SICI)1097-0142(19981215)83:12<2521::AID-CNCR17>3.0.CO;2-A PMID:9874458

Jäger W, Eibner K, Löffler B, Gleixner S, Krämer S. Serial CEA and CA 15-3 measurements during follow-up of breast cancer patients. Anticancer Res. 2000;20(6D):5179-5182. PMID:11326691

Zhao S, Mei Y, Wang J, Zhang K, Ma R. Different levels of CEA, CA153 and CA125 in milk and benign and malignant nipple discharge. PLoS One. 2016;11(6):e0157639. https://doi.org/10.1371/journal.pone.0157639 PMID:27327081

Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471-4. https://doi.org/10.1245/s10434-010-0985-4 PMID:20180029

Vizcarra E, Lluch A, Cibrián R, et al. Value of CA 15.3 in breast cancer and comparison with CEA and TPA: a study of specificity in disease-free follow-up patients and sensitivity in patients at diagnosis of the first metastasis. Breast Cancer Res Treat. 1996;37(3):209-216. https://doi.org/10.1007/BF01806502 PMID:8825132

Geraghty JG, Coveney EC, Sherry F, O’Higgins NJ, Duffy MJ. CA 15-3 in patients with locoregional and metastatic breast carcinoma. Cancer. 1992;70(12):2831-2834. https://doi.org/10.1002/1097-0142(19921215)70:12<2831::AID-CNCR2820701218>3.0.CO;2-8PMID:1451063

Ebeling FG, Stieber P, Untch M, et al. Serum CEA and CA 15-3 as prognostic factors in primary breast cancer. Br J Cancer. 2002;86(8):1217-1222. https://doi.org/10.1038/sj.bjc.6600248PMID:11953875

Banin Hirata BK, Oda JM, Losi Guembarovski R, Ariza CB, de Oliveira CE, Watanabe MA. Molecular markers for breast cancer: prediction on tumor behavior. Dis Markers. 2014;2014:513158. https://doi.org/10.1155/2014/513158 PMID:24591761

Moazzezy N, Farahany TZ, Oloomi M, Bouzari S. Relationship between preoperative serum CA 15-3 and CEA levels and clinicopathological parameters in breast cancer. Asian Pac J Cancer Prev. 2014;15(4):1685-1688. https://doi.org/10.7314/APJCP.2014.15.4.1685 PMID:24641390

Agrawal AK, Jelen M, Rudnicki J, et al. The importance of preoperative elevated serum levels of CEA and CA15-3 in patients with breast cancer in predicting its histological type. Folia Histochem Cytobiol. 2010;48(1):26-29. https://doi.org/10.2478/v10042-010-0030-2PMID:20529812

Fu Y, Li H. Assessing clinical significance of serum CA15-3 and carcinoembryonic antigen (CEA) Levels in breast cancer patients: a meta-analysis. Med Sci Monit. 2016;22:3154-3162. https://doi.org/10.12659/MSM.896563 PMID:27596019

Yang Y, Zhang H, Zhang M, Meng Q, Cai L, Zhang Q. Elevation of serum CEA and CA15-3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients. Oncol Lett. 2017;14(6):7549-7556. https://doi.org/10.3892/ol.2017.7164PMID:29344201

Duffy MJ. Serum tumor markers in breast cancer: are they of clinical value? Clin Chem. 2006;52(3):345-351. https://doi.org/10.1373/clinchem.2005.059832 PMID:16410341

Al-azawi D, Kelly G, Myers E, et al. CA 15-3 is predictive of response and disease recurrence following treatment in locally advanced breast cancer. BMC Cancer. 2006;6(1):220. https://doi.org/10.1186/1471-2407-6-220 PMID:16953875

Nisman B, Maimon O, Allweis T, et al. The prognostic significance of LIAISON(R) CA15-3 assay in primary breast cancer. Anticancer Res. 2013;33(1):293-299. PMID:23267160

Kim HS, Park YH, Park MJ, et al. Clinical significance of a serum CA15-3 surge and the usefulness of CA15-3 kinetics in monitoring chemotherapy response in patients with metastatic breast cancer. Breast Cancer Res Treat. 2009;118(1):89-97. https://doi.org/10.1007/s10549-009-0377-2 PMID:19322651

Agha-Hosseini F, Mirzaii-Dizgah I, Rahimi A. Correlation of serum and salivary CA15-3 levels in patients with breast cancer. Med Oral Patol Oral Cir Bucal. 2009;14(10):e521-e524. https://doi.org/10.4317/medoral.14.e521 PMID:19680209

Ali HQ, Mahdi NK, Al-Jowher MH. The value of CA15-3 in diagnosis, prognosis and treatment response in women with breast cancer. J Pak Med Assoc. 2013;63(9):1138-1141. PMID:24601193

Kobayashi S, Iwase H, Karamatsu S, Matsuo K, Masaoka A, Miyagawa T. The clinical value of serum CA15-3 assay postoperatively in breast cancer patients. Jpn J Surg. 1989;19(3):278-282. https://doi.org/10.1007/BF02471402 PMID:2779026

Di Gioia D, Heinemann V, Nagel D, et al. Kinetics of CEA and CA15-3 correlate with treatment response in patients undergoing chemotherapy for metastatic breast cancer (MBC). Tumour Biol. 2011;32(4):777-785. https://doi.org/10.1007/s13277-011-0180-7 PMID:21553235

Devine PL, Duroux MA, Quin RJ, et al. CA15-3, CASA, MSA, and TPS as diagnostic serum markers in breast cancer. Breast Cancer Res Treat. 1995;34(3):245-251. https://doi.org/10.1007/BF00689716 PMID:7579489

Thriveni K, Krishnamoorthy L, Ramaswamy G. Correlation study of carcino embryonic antigen & cancer antigen 15.3 in pretreated female breast cancer patients. Indian J Clin Biochem. 2007;22(1):57-60. https://doi.org/10.1007/BF02912882 PMID:23105653

Sørbye H, Dahl O. Transient CEA increase at start of oxaliplatin combination therapy for metastatic colorectal cancer. Acta Oncol. 2004;43(5):495-498. https://doi.org/10.1080/02841860410032380 PMID:15360055

Ailawadhi S, Sunga A, Rajput A, Yang GY, Smith J, Fakih M. Chemotherapy-induced carcinoembryonic antigen surge in patients with metastatic colorectal cancer. Oncology. 2006;70(1):49-53. https://doi.org/10.1159/000091184 PMID:16446549

Strimpakos AS, Cunningham D, Mikropoulos C, Petkar I, Barbachano Y, Chau I. The impact of carcinoembryonic antigen flare in patients with advanced colorectal cancer receiving first-line chemotherapy. Ann Oncol. 2010;21(5):1013-1019. https://doi.org/10.1093/annonc/mdp449PMID:19861580

Takahashi N, Shimada T, Ishibashi Y, Oyake N, Murakami Y. Transient elevation of serum tumor markers in a patient with hypothyroidism. Am J Med Sci. 2007;333(6):387-389. https://doi.org/10.1097/MAJ.0b013e318065b023 PMID:17570994

Klapdor R, Bahlo M, Babinski A. Atypical courses of serum tumor markers—4 case reports. Anticancer Res. 2003;23(2A):845-850. PMID:12820311

Harris L, Fritsche H, Mennel R, et al; American Society of Clinical Oncology. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol. 2007;25(33):5287-5312. https://doi.org/10.1200/JCO.2007.14.2364PMID:17954709

Published

2022-11-07

How to Cite

1.
Hasan D. Diagnostic impact of CEA and CA 15-3 on monitoring chemotherapy of breast cancer patients: Chemotherapy monitoring by serum markers. J Circ Biomark [Internet]. 2022 Nov. 7 [cited 2022 Dec. 6];11(1):57-63. Available from: https://journals.aboutscience.eu/index.php/jcb/article/view/2446

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Original research article