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Chen Y, Wang L, Zhu Y, Chen Z, Qi X, Jin L, Jin J, Hua D, Ma X. Breast cancer resistance protein (BCRP)-containing circulating microvesicles contribute to chemoresistance in breast cancer. Oncol Lett 2015; 10:3742-3748. [PMID: 26788201 DOI: 10.3892/ol.2015.3806] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 09/17/2015] [Indexed: 02/06/2023] Open
Abstract
At present, one of the major problems of cancer therapy is drug resistance. Breast cancer resistance protein (BCRP), a marker of the multidrug-resistant phenotype, affects drug absorption, distribution, metabolism, and excretion in normal tissues. Meanwhile, extracellular vesicles (EVs) have attracted increasing attention as a medium of cell-to-cell communication. However, the association between BCRP and circulating EVs remains unclear. The present study demonstrated that patients who did not respond or had progressive/stable disease following chemotherapy had markedly higher BCRP levels compared to those that did not receive chemotherapy. Moreover, BCRP was upregulated at the mRNA and protein levels in tumor-derived circulating EVs from patients with a poor response to chemotherapy. Interestingly, the results also demonstrated that BCRP was co-expressed with MUC1, which is frequently expressed in breast cancer and is exported via EVs, and both BCRP and MUC1 were up-regulated after chemotherapy. In conclusion, the present study indicates that tumor-derived circulating EVs that carry BCRP may serve as a predictive biomarker of the response to chemotherapy for breast cancer. In addition, the results provide a window for individualized treatment to overcome resistance to chemotherapeutic drugs.
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Affiliation(s)
- Yun Chen
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Linjun Wang
- Department of Medical Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 204062, P.R. China
| | - Yifei Zhu
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Zhen Chen
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Xiaowei Qi
- Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 204062, P.R. China
| | - Linfang Jin
- Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 204062, P.R. China
| | - Jian Jin
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
| | - Dong Hua
- Department of Medical Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 204062, P.R. China; Department of Pathology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu 204062, P.R. China
| | - Xin Ma
- School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122, P.R. China
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Almufti R, Wilbaux M, Oza A, Henin E, Freyer G, Tod M, Colomban O, You B. A critical review of the analytical approaches for circulating tumor biomarker kinetics during treatment. Ann Oncol 2014; 25:41-56. [PMID: 24356619 DOI: 10.1093/annonc/mdt382] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Changes in serum tumor biomarkers may indicate treatment efficacy. Traditional tumor markers may soon be replaced by novel serum biomarkers, such as circulating tumor cells (CTCs) or circulating tumor nucleic acids. Given their promising predictive values, studies of their kinetics are warranted. Many methodologies meant to assess kinetics of traditional marker kinetics during anticancer treatment have been reported. Here, we review the methodologies, the advantages and the limitations of the analytical approaches reported in the literature. Strategies based on a single time point were first used (baseline value, normalization, nadir, threshold at a time t), followed by approaches based on two or more time points [half-life (HL), percentage decrease, time-to-events…]. Heterogeneities in methodologies and lack of consideration of inter- and intra-individual variability may account for the inconsistencies and the poor utility in routine. More recently, strategies based on a population kinetics approach and mathematical modeling have been reported. The identification of equations describing individual kinetic profiles of biomarkers may be an alternative strategy despite its complexity and higher number of necessary measurements. Validation studies are required. Efforts should be made to standardize biomarker kinetic analysis methodologies to ensure the optimized development of novel serum biomarkers and avoid the pitfalls of traditional markers.
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Affiliation(s)
- R Almufti
- Service d'Oncologie Médicale, Investigational Center for Treatments in Oncology and Hematology of Lyon, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
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3
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Toulmonde M, Madranges N, Brouste V, Donamaria C, MacGrogan G, Durand M, Bonnefoi H, Mauriac L, Debled M. Docetaxel rechallenge after a first response in non-resistant metastatic breast cancer: significant activity with manageable toxicity. Breast Cancer Res Treat 2012; 134:325-32. [DOI: 10.1007/s10549-012-2060-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 04/01/2012] [Indexed: 10/28/2022]
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Abramson VG, Mayer IA. Clinical utility of serum tumor markers and circulating tumor cell assays in the treatment of breast cancer. Curr Treat Options Oncol 2012; 12:403-11. [PMID: 21918859 DOI: 10.1007/s11864-011-0164-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OPINION STATEMENT Though serum tumor markers and circulating tumor cells (CTCs) have been available to the oncologist for many years, their place in the management of breast cancer remains unclear. Due to issues with sensitivity and specificity, tumor markers are unreliable for the detection of metastases in early stage breast cancer. For patients with metastatic breast cancer without measurable disease (e.g., bone-only disease, pleural effusions, or ascites), it is reasonable to obtain baseline values of serum tumor markers and attempt to correlate them with the first set of scans. In patients with elevated markers at baseline whose tumor marker levels decrease in correlation with an improvement in clinical symptoms, it may be reasonable to use them in conjunction with imaging to help determine whether there is progression of disease. CTCs have been found to hold strong prognostic value for breast cancer in both the early stage and metastatic settings. No large prospective studies to date, however, have shown any predictive value for CTCs and their clinical utility is therefore limited. Whether changing treatment in response to an increase in CTCs without radiologic progression results in improvements in quality of life or survival remains to be seen. CTCs hold great promise in the management of breast cancer and future studies will help delineate their role more appropriately.
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Affiliation(s)
- Vandana G Abramson
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Vanderbilt-Ingram Cancer Center, Nashville, TN 37212, USA.
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Abstract
Mammography is a powerful screening tool for early detection of breast cancer, but it has limitations in terms of both specificity and sensitivity. Imaging tools such as MRI that complement mammography are too costly to serve as first-line screens. Recently, progress has been made on blood markers, particularly microRNAs and proteins. There are new methods for protein marker discovery directly in blood, but they are limited in the number of patients that can be examined. An alternative is to discover markers as transcripts in tissues, followed by development of blood protein tests for those that perform best. To identify genes that are overexpressed in malignancy it is paramount to include normal control tissues from healthy individuals. Here we report the identification of potential breast cancer markers, including some that are overexpressed in aggressive disease.
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Affiliation(s)
- Michèl Schummer
- Molecular Diagnostics Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
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Chen Y, Ying M, Chen Y, Hu M, Lin Y, Chen D, Li X, Zhang M, Yun X, Zhou J, He E, Skog S. Serum thymidine kinase 1 correlates to clinical stages and clinical reactions and monitors the outcome of therapy of 1,247 cancer patients in routine clinical settings. Int J Clin Oncol 2010; 15:359-68. [PMID: 20354751 DOI: 10.1007/s10147-010-0067-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 02/05/2010] [Indexed: 01/21/2023]
Abstract
BACKGROUND Thymidine kinase 1 in serum (STK1) has been found to be a reliable proliferation marker in clinical trials. In this study, we examined the significance of STK1 in routine clinical settings. METHODS The concentration of STK1 was determined by a sensitive dot blot ECL assay. The STK1 value was correlated to clinical stage and reactions and used for monitoring the outcome of surgery and/or multidrug chemotherapy of 1,247 patients with five different types of carcinomas (lung, esophagus, gastric, head and neck, and thyroid) in routine clinical settings. RESULTS The STK1 values correlated with the clinical stage in patients with lung, esophagus, thyroid, and gastric carcinomas. After treatment, STK1 declined in all tumor groups after treatments (P < 0.01). The STK1 was low (<2 pM) or decreasing during treatment in patients with clinical reactions of complete response (CR) or partial response (PR), but high (>2 pM) or increasing in patients with stable disease (SD) or progressive disease (PD), some of them showing metastasis. STK1 also reflected the differences in clinical reactions when surgery and chemotherapy were compared. CONCLUSION We concluded that the concentration of TK1 in serum correlates to clinical stages and clinical reactions and monitors the effect of tumor therapies, not only in controlled clinical trials, but also in routine clinical settings.
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Affiliation(s)
- Yan Chen
- Laboratory of Biochemistry and Molecular Biology Research, Fujian Cancer Hospital of Fujian Medical University Teaching Hospital, Fuzhou, Fujian 350014, China.
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Harris L, Fritsche H, Mennel R, Norton L, Ravdin P, Taube S, Somerfield MR, Hayes DF, Bast RC. American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer. J Clin Oncol 2007; 25:5287-312. [PMID: 17954709 DOI: 10.1200/jco.2007.14.2364] [Citation(s) in RCA: 1544] [Impact Index Per Article: 90.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To update the recommendations for the use of tumor marker tests in the prevention, screening, treatment, and surveillance of breast cancer. METHODS For the 2007 update, an Update Committee composed of members from the full Panel was formed to complete the review and analysis of data published since 1999. Computerized literature searches of MEDLINE and the Cochrane Collaboration Library were performed. The Update Committee's literature review focused attention on available systematic reviews and meta-analyses of published tumor marker studies. In general, significant health outcomes (overall survival, disease-free survival, quality of life, lesser toxicity, and cost-effectiveness) were used for making recommendations. Recommendations and CONCLUSIONS Thirteen categories of breast tumor markers were considered, six of which were new for the guideline. The following categories showed evidence of clinical utility and were recommended for use in practice: CA 15-3, CA 27.29, carcinoembryonic antigen, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, urokinase plasminogen activator, plasminogen activator inhibitor 1, and certain multiparameter gene expression assays. Not all applications for these markers were supported, however. The following categories demonstrated insufficient evidence to support routine use in clinical practice: DNA/ploidy by flow cytometry, p53, cathepsin D, cyclin E, proteomics, certain multiparameter assays, detection of bone marrow micrometastases, and circulating tumor cells.
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8
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Cheung KL. Endocrine therapy for breast cancer: an overview. Breast 2007; 16:327-43. [PMID: 17499991 DOI: 10.1016/j.breast.2007.03.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2007] [Revised: 03/19/2007] [Accepted: 03/22/2007] [Indexed: 01/08/2023] Open
Abstract
Endocrine therapy for breast cancer has been established in the adjuvant treatment for primary disease and in the treatment of advanced disease. The ER remains the best predictor of response although other factors exist and need to be identified. Pharmacological manipulation has been replacing ablative procedures. Tamoxifen used to be the most popular agent of choice and promising new agents include the pure anti-oestrogens and the third generation selective aromatase inhibitors. Ongoing and future studies will optimise treatment in established areas and will exploit its potential roles in preoperative use and chemoprevention.
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Affiliation(s)
- K L Cheung
- Division of Breast Surgery, University of Nottingham, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
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Forward DP, Cheung KL, Jackson L, Robertson JFR. Clinical and endocrine data for goserelin plus anastrozole as second-line endocrine therapy for premenopausal advanced breast cancer. Br J Cancer 2004; 90:590-4. [PMID: 14760369 PMCID: PMC2409605 DOI: 10.1038/sj.bjc.6601557] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A total of 16 premenopausal women with metastatic breast cancer (N=13) or locally advanced primary breast cancer (N=3) were treated with a combination of a gonadotropin-releasing hormone agonist goserelin, and a selective aromatase inhibitor anastrozole. All had previously been treated with goserelin and tamoxifen. In all, 12 patients (75%) achieved objective response or durable stable disease at 6 months, with a median duration of remission of 17+ months (range 6–47 months). Four patients still have clinical benefit. Introduction of goserelin and tamoxifen resulted in an 89% reduction in mean oestradiol levels (pretreatment vs 6 months=224 vs 24 pmol l−1) (P<0.0001). Substitution of tamoxifen by anastrozole on progression resulted in a further 76% fall (to 6 pmol l−1 at 3 months) (P<0.0001). Treatment with goserelin and tamoxifen led to a 90% fall in the mean follicle-stimulating hormone (P<0.001). This was reversed once therapy was changed to goserelin and anastrozole. A similar initial reduction was seen in the mean luteinising hormone levels, but substitution of tamoxifen by anastrozole on progression resulted in no significant change. Goserelin and tamoxifen did not lead to any significant change in testosterone and androstenedione levels. The combined use of goserelin and anastrozole as second-line endocrine therapy produces a significant clinical response of worthwhile duration, with demonstrable endocrine changes, in premenopausal women with advanced breast cancer, and offers them another therapeutic option. Further studies involving more patients and longer follow-up are indicated.
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Affiliation(s)
- D P Forward
- Professorial Unit of Surgery, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - K L Cheung
- Professorial Unit of Surgery, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
- Professorial Unit of Surgery, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. E-mail:
| | - L Jackson
- Professorial Unit of Surgery, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
| | - J F R Robertson
- Professorial Unit of Surgery, City Hospital, Hucknall Road, Nottingham NG5 1PB, UK
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Nishimura R, Nagao K, Miyayama H, Matsuda M, Baba KI, Matsuoka Y, Yamashita H. Elevated serum CA15-3 levels correlate with positive estrogen receptor and initial favorable outcome in patients who died from recurrent breast cancer. Breast Cancer 2004; 10:220-7. [PMID: 12955034 DOI: 10.1007/bf02966721] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The clinical usefulness of circulating tumor markers in breast cancer as recurrence indicators during follow-up or monitoring treatment response is still an open question. There are some patients with normal tumor marker levels who have apparent recurrence foci. In this study, we evaluated the relationships between CEA or CA15-3 levels and clinicopathological factors or outcome in patients who had died from recurrent breast cancer. METHODS Two hundred-twenty deceased patients who had had recurrent or advanced breast cancer and who had been treated between 1986 and 2000 were enrolled in a retrospective study. Serum CEA and CA 15-3 were measured regularly during the clinical course until death. RESULTS The rates of CEA and CA15-3 positivity were 41.4% and 50.9% at the time of recurrence, and rose to 67.3% and 76.8% after recurrence, respectively. The CA15-3 and CEA positivity rates significantly correlated with ER and PgR status. Serum CA15-3 status correlated significantly with survival after recurrence. Patients with CA15-3 negativity had poorer prognoses than CA15-3 positive patients. Multivariate analysis revealed that CA15-3 status was one of the significant factors for survival after recurrence. CONCLUSIONS Tumor markers, especially CA15-3, might reflect the biological characteristics of tumors such as ER or PgR status, and may be useful prognostic predictors in recurrent breast cancer. Elevated CA15-3 levels correlated with positive estrogen receptor and favorable outcome in deceased patients with recurrent breast cancer.
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Affiliation(s)
- Reiki Nishimura
- Department of Surgery, Kumamoto City Hospital, 1-1-60 Kotoh, Kumamoto City, Kumamoto 862-8505, Japan.
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James JJ, Evans AJ, Pinder SE, Gutteridge E, Cheung KL, Chan S, Robertson JFR. Bone metastases from breast carcinoma: histopathological - radiological correlations and prognostic features. Br J Cancer 2003; 89:660-5. [PMID: 12915874 PMCID: PMC2376918 DOI: 10.1038/sj.bjc.6601198] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to identify factors that may be associated with the development of bone metastases in patients with metastatic breast carcinoma and to see if any of these factors had a bearing on subsequent survival. In total, 492 patients presented to the Nottingham City Hospital with metastatic breast carcinoma between July 1997 and December 2001. Of these, 267 patients had bone metastases at presentation with metastatic disease, 91 patients in this group had bone as their only site of metastatic disease. Sites of first presentation of metastatic disease were prospectively recorded, as were histological features of the primary tumour (tumour type, histological grade, lymph node stage, tumour size and oestrogen receptor (ER) status). The radiological features of the bone metastases, the metastasis-free interval and serological tumour marker levels at presentation with metastases were all recorded. There was a significant association between the development of bone metastases and lower grade tumours (P=0.019), ER-positive tumours (P<0.0001) and the lymph node stage of the primary tumour (P=0.047). A multivariate analysis found that metastasis-free interval, additional sites of metastatic disease other than bone, ER status and serological tumour marker levels all independently contributed to survival from time of presentation with bone metastases.
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Affiliation(s)
- J J James
- Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
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