CA 15-3, Ceruloplasmin and tissue polypeptide specific antigen as a tumour marker panel in breast cancer

Background: Tumour markers along with other tests, may be useful in the assessment of the prognosis, monitoring response to treatment and early detection of metastases in breast cancer. The most commonly used breast cancer antigen is CA 15-3.Objective: To examine the value of CA 15-3, ceruloplasmin and tissue polypeptide specific antigen (TPS) panel in the monitoring of breast cancer.Subjects: Serum concentrations of CA 15-3, ceruloplasmin and TPS were measured in 90 women: Fifteen controls, sixteen patients with benign breast disease (BBD), thirty one patients in remission and twenty eight patients with active breast cancer.Results: The results of CA 15-3, ceruloplasmin and TPS estimates were separated into four groups. The patients not in remission were found to have significantly higher levels of CA 15-3 (p0.05). The sensitivities of CA 15-3, ceruloplasmin, and TPS for detecting active breast cancer were 75.0%, 75.0%, and 78.0%, respectively.Conclusion: The highest sensitivity for active breast cancer detection was obtained by the combined use of three tumour markers. We concluded that there may be an advantage in using panels in the follow up of breast cancer patients, although so far such tests have too lowa specificity to be of practical value in screening

Cisplatin plus oral etoposide (EoP) combination is more effective than paclitaxel in patients with advanced breast cancer pretreated with anthracyclines: a randomised phase III trial of Turkish Oncology Group

Our objective was to determine whether oral etoposide and cisplatin combination (EoP) is superior to paclitaxel in the treatment of advanced breast cancer (ABC) patients pretreated with anthracyclines. From December 1997 to August 2003, 201 patients were randomised, 100 to EoP and 101 to paclitaxel arms. Four patients in each arm were ineligible. The doses of etoposide and cisplatin were 50 mg p.o. twice a day for 7 days and 70 mg m−2 intravenously (i.v.) on day 1, respectively, and it was 175 mg m−2 on day 1 for paclitaxel. Both treatments were repeated every 3 weeks. A median of four cycles of study treatment was given in both arms. The response rate obtained in the EoP arm was significantly higher (36.3 vs 22.2%; P=0.038). Median response duration was longer for the EoP arm (7 vs 4 months) (P=0.132). Also, time to progression was significantly in favour of the EoP arm (5.5 vs 3.9 months; P=0.003). Median overall survival was again significantly longer in the EoP arm (14 vs 9.5 months; P=0.039). Toxicity profile of both groups was similar. Two patients in each arm were lost due to febrile neutropenia. The observed activity and acceptable toxicity of EoP endorses the employment of this combination in the treatment of ABC following anthracyclines

The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: A report from the Euro Heart Survey on Coronary Revascularisation

Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (≤ 60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81). Conclusions: This analysis shows that impaired health status is associated with a 2-3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients' subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice

Weekly Paclitaxel In Pretreated Metastatic Breast Cancer: Retrospective Analysis Of 52 Patients

Single-agent paclitaxel has been shown to be effective as both first- and second-line treatment of metastatic breast cancer, and the efficacy and tolerability of weekly administration of paclitaxel has generated much interest. Fifty-two patients with pretreated metastatic breast cancer who were admitted to Hacettepe University between January 2001 and June 2002 were retrospectively analyzed in this study. Paclitaxel was administered weekly in a dose of 80 mg/m(2) over 1 hour. The median number of cycles delivered was 20 weeks (range, 8 to 24). The median delivered dose was 2400 mg (range, 960 to 3840 mg). At a median follow-up of 12.3 months (range, 6 to 17), all patients were assessable for response and toxicity. A complete response and partial response were observed in 7 (13.5%), and 19 (36.5%) patients, respectively. Overall response rate was 50%. Median duration of response was 10 months (range, 3 to 16). Therapy was generally well tolerated, and toxicities were manageable. Severe leukopenia was seen in two (4%) patients. Based on these results, we conclude that weekly paclitaxel is a well-tolerated and highly effective regimen in pre-treated metastatic breast cancer. (C) 2004 Tohoku University Medical Press.WoSScopu

Neoadjuvant chemotherapy in locally advanced breast cancer: A preliminary report

Aims and background: A pilot study of neoadjuvant chemotherapy with cyclophosphamide-epirubicin-5-fluorouracil (FEC) was performed on 85 patients with locally advanced breast cancer

Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer: A Preliminary Report

Aims and background: A pilot study of neoadjuvant chemotherapy with cyclophosphamide-epirubicin-5-fluorouracil (FEC) was performed on 85 patients with locally advanced breast cancer

Expression of PTEN, cyclin D1, P27/KIP1 in invasive ductal carcinomas of the breast and correlation with clinicopathological parameters.

In this study, tumour tissue samples of 85 primary breast cancer patients were evaluated for phosphatase and tensin homolog deleted on chromosome ten (PTEN), cyclin D1 and P27/Kip1 expression patterns. The results were correlated with clinicopathological parameters. Loss of PTEN protein expression was present in 32.5% of the cases. Cyclin D1 was overexpressed in 54.2% and P27/Kip1 in 89.3% of the cases. Statistically significant associations were found between PTEN and cyclin D1 expression patterns, and cyclin D1 expression and tumour size

Detection of insulin resistance in Turkish adults: A hospital-based study

PubMedID: 12630938Aim: The aim of the present study was to investigate the usefulness of insulin sensitivity check indices in our hospital population. Methods: Both HOMA (insulin X glucose in mmol/l/22.5) and QUICKI (1/log insulin in µu/ml + log glucose in mg/dl) indices were calculated from fasting values in 1774 subjects from the medical records of Baskent University Adana Hospital. Results: Subjects with diabetes, hyperlipidaemia and central obesity were characterized by significantly higher HOMA and lower QUICKI indices than those of healthy subjects. A fall in the QUICKI index (0.3469 ± 0.028 in healthy subjects and 0.3247 ± 0.025 in non-obese diabetics) as well as an increase in HOMA index (2.24 ± 1.26 in healthy subjects and 3.59 ± 2.08 in non-obese diabetics) corresponded to metabolic and clinical manifestations of insulin resistance in various groups of subjects. Age, low HDL cholesterol, male sex, type 2 DM and hypertension were independent risk factors for CAD. Age, male sex, waist circumference and CAD were found to be risk factors for hypertension. Fasting insulin and glucose levels contain sufficient information to assess insulin sensitivity over a wide range in a diverse population. The following can be accepted as mean values to assess insulin resistance in our hospital population: 0.3469 ± 0.028 for the QUICKI index and 2.24 ± 1.26 for the HOMA index. Conclusions: HOMA and QUICKI indices are simple and reproducible methods for determining insulin sensitivity in humans