85192
document
Continuous chemotherapy in responsive metastatic breast cancer : a role for tumour markers ? A biochemical response index comprising ESR , CEA and CA 15.3 was evaluated in 67 patients with systemic breast cancer treated by chemotherapy ; 55 were assessable by UICC criteria and the response index ( 96 % of all UICC assessable patients ) . Marker changes at 2 and 4 months showed a highly significant correlation with the UICC assessed response at 3 and 6 months ( P < 0.001 ) ; sensitivity 100 % , specificity 87 % ; positive predictive value 85 % ; negative predictive value 100 % . This index was then used to select out truly responsive patients and to prospectively direct their chemotherapy . Twenty-six responding ( biochemical/clinical ) patients were randomised to discontinue cytotoxics after 6 months and move to maintenance hormones ( n = 13 ) or continue chemotherapy whilst the biochemical markers kept falling or remained within the normal range . Biochemical progression prompted a change of chemotherapy . Continuous chemotherapy in biochemically defined responders was associated with a significant lengthening of remission duration and an improved quality of life and survival . We are now using the index to routinely direct chemotherapy and select out true responders for maintenance chemotherapy .
85193
Intervention_Pharmacological
Continuous chemotherapy
85194
Intervention_Pharmacological
chemotherapy
85195
Intervention_Pharmacological
discontinue cytotoxics after 6 months and move to maintenance hormones
85196
Intervention_Pharmacological
continue chemotherapy
85197
Intervention_Pharmacological
Continuous chemotherapy
85198
Outcome_Physical
lengthening of remission duration
85199
Outcome_Physical
improved quality of life
85200
Outcome_Mortality
survival
85201
Participant_Condition
metastatic breast cancer
85202
Participant_Sample-size
67
85203
Participant_Condition
systemic breast cancer treated by chemotherapy
85204
Participant_Sample-size
55
85205
Participant_Condition
assessable by UICC criteria