Tumor factors predicting for prognosis in metastatic breast cancer: the presence of P24 predicts for response to treatment and duration of survival

Article Abstract:

Traditionally, patient status, tumor stage, and tumor grade have been the only prognostic factors for cancer. In recent years, however, the availability of sophisticated immunological and molecular biological techniques has prompted interest in the study of many physiological substances that may serve as useful prognostic factors in cancer patients. Cellular receptors for the hormones estrogen and progesterone have been widely studied and may be important indicators in some patients with breast cancer. The binding of estrogen to estrogen receptors results in a complex series of events; one of the results of these events, in some cells, is the synthesis of a 24 kiloDalton protein called simply P24. In a study of 51 patients with metastatic breast cancer, the appearance of P24 in the breast cancer cells was correlated with improved response to treatment. Immunocytochemical techniques were used to stain tissue sections of the breast cancer specimens, and specimens with more than 10 percent of the cells staining were regarded as positive. The patients with positive tumors had a greater rate of response to treatment, a greater duration of the response, and a longer survival from the diagnosis of metastatic disease. Although there was a significant correlation between the presence of P24 protein and estrogen receptors among the cancers studied, only P24 was found to be a significant prognostic factor in this patient group. Although the actual function of P24 is poorly understood, evidence is accumulating that the protein may be identical to heat shock protein 27 (hsp 27), which was first identified in a different context. This seems almost contradictory, since other studies have shown that hsp 27 is an indicator of poor prognosis in breast cancer. The authors suggest that the Pp24/hsp 27 protein may be correlated with a higher rate of metastasis, but when patients with metastatic disease alone are studied, the same protein may correlate with a better response to treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Heat shock proteins, Tumor proteins

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Circulating tumor marker levels in advanced breast carcinoma correlate with the extent of metastatic disease

Article Abstract:

Recently, much research has focused on the use of tumor markers as diagnostic and prognostic tools. The markers, which are antigens specific to tumor cells, may be found circulating in the blood of many tumor patients. To determine if CA 15-3 and carcinoembryonic antigen (CEA) might be important in the diagnosis of metastatic disease in patients with breast cancer, the circulating levels of these antigens were measured in 173 patients. The extent of metastatic disease was estimated, and the organs involved were also evaluated. Elevated values of CA 15-3 were seen in 130 patients, while elevated values of CEA were observed in 97, a statistically significant difference. The quantity of circulating CA 15-3 was a better predictor of the extent of metastatic disease than was CEA. Elevated CA 15-3 correlated with extent of disease, number of metastases, and survival, whereas CEA correlated more weakly only with extent of disease. The prediction possible with knowledge of both CA 15-3 and CEA levels was better than the prediction possible with CA 15-3 levels alone. Although the level of CA 15-3 also correlated with degree of organ involvement, this was due to the overall correlation with extent of disease, since some organs tend to become involved sooner than others. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer, Tumor antigens, Tumor markers

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Survival of premenopausal women with metastatic breast cancer: long-term follow-up of Eastern Cooperative Group and Cancer and Leukemia Group B studies

Article Abstract:

Long-term follow-up is an important part of evaluating cancer prognosis and treatment, since misleading differences between groups or treatments may appear in early follow-up which are no longer present when longer periods are considered. In addition, there are instances in which some treatments may provide greater intervals of freedom from disease without extending survival. The authors combined the data from three studies of the long-term survival of over 10,000 premenopausal women with metastatic breast cancer. In contrast to the relatively good prognosis of postmenopausal patients, the prognosis of the premenopausal women was generally poor, and the median survival was less than 30 months. Younger age was significantly associated with a poor prognosis, as was disease which had spread to the viscera (internal organs). As is the case with breast cancer in other patients, the absence of estrogen receptors was found to be associated with poorer survival. Of the 11,733 women who joined the studies, which began between 1973 and 1978, only 14 percent are still alive. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer metastasis

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