Use of Granulocyte-colony Stimulating Factor During Chemotherapy and Its Association With CA27.29 and Circulating Tumor Cells-Results From the SUCCESS A Trial

Hepp, Philip; Fasching, Peter A.; Beckmann, Matthias W.; Fehm, Tanja; Salmen, Jessica; Hagenbeck, Carsten; Jaeger, Bernadette; Widschwendter, Peter; Gregorio, Nikolaus de; Schochter, Fabienne; Mahner, Sven; Harbeck, Nadia; Weissenbacher, Tobias; Kurt, Ayse-Guel; Friedl, Thomas W. P.; Janni, Wolfgang und Rack, Brigitte (2018): Use of Granulocyte-colony Stimulating Factor During Chemotherapy and Its Association With CA27.29 and Circulating Tumor Cells-Results From the SUCCESS A Trial. In: Clinical Breast Cancer, Bd. 18, Nr. 5, E1103-E1110

Abstract

D The present study examined the association between granulocyte colony-stimulating factor (G-CSF) and prognostic markers cancer antigen (CA)27.29 and circulating tumor cells (CTCs) in 2646 early-stage breast cancer patients. Those with G-CSF application showed a significantly greater increase in CA27.29 levels after chemotherapy than those without any G-CSF application during chemotherapy, although no association with CTCs was found. Background: Little is known about the effect of granulocyte colony-stimulating factor (G-CSF) treatment during adjuvant chemotherapy on prognostic markers. The present study explored the association between G-CSF and changes in cancer antigen (CA) 27.29 and circulating tumor cell (CTC) levels during therapy. Patients and Methods: A total of 3754 node-positive or high-risk node-negative early-stage breast cancer patients were treated within the SUCCESS-A trial (simultaneous study of gemcitabine-docetaxel combination adjuvant treatment, as well as extended bisphosphonate and surveillance-trial). CA27.29 and CTCs were determined before the start and within 6 weeks after the end of chemotherapy. Results: Overall, 1324 of the 2646 patients (50.0%) available for analysis had >= 1 G-CSF applications during chemotherapy. G-CSF application was significantly associated with CA27.29 status before and after chemotherapy (chi(2) = 30.6, df = 3;P < .001), because 238 patients (18.0%) with G-CSF treatment but only 146 (11.0%) without G-CSF treatment switched from a negative CA27.29 status before to a positive CA27.29 status after chemotherapy. In addition, patients with G-CSF application showed a significantly greater increase in CA27.29 levels after chemotherapy compared with patients without any G-CSF application during chemotherapy (Mann-Whitney U test;Z - -7.81, P < .001). No significant association was found between G-CSF application and CTC status before or after chemotherapy (chi(2) = 1.2, df = 3;P = .75). Conclusion: Cautious interpretation is needed regarding elevated levels of MUC-1 - derived tumor markers such as CA27.29 shortly after adjuvant chemotherapy when G-CSF has been given, because G-CSF treatment was associated with increased CA27.29 levels after chemotherapy.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1526-8209
• Sprache: Englisch