The role of cancer antigen 15-3 and carcinoembryonic antigen in assessing treatment response in patients with metastatic breast cancer

Hsu Wint Phyo; Myo Myint Maw; Zun Thynn; Kyaw Swa Mya

doi:10.18203/2394-6040.ijcmph20250600

Authors

Hsu Wint Phyo Medical Oncological Department, Yangon General Hospital, University of Medicine (1), Yangon, Myanmar
Myo Myint Maw Medical Oncological Department, Yangon General Hospital, University of Medicine (1), Yangon, Myanmar
Zun Thynn Medical Oncological Department, Yangon General Hospital, University of Medicine (1), Yangon, Myanmar
Kyaw Swa Mya Preventive and Social Medicine Department, University of Medicine, Taunggyi https://orcid.org/0000-0003-1286-1409

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20250600

Keywords:

Metastatic breast cancer chemotherapy, Cancer antigen 15-3, Carcinoembryonic antigen

Abstract

Background: In breast cancer, the most widely used tumor markers are cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA). These markers are primarily used for surveillance purposes and monitoring of treatment responses in clinical practice. This study aims to examine the role of CA 15-3 and CEA in assessing treatment response in patients with metastatic breast cancer (MBC).

Methods: This study investigated 45 MBC patients who met the eligibility criteria. We evaluated the levels of CA 15-3 and CEA before chemotherapy, after 3 months, and after 6 months. The response to therapy was assessed by imaging.

Results: There were statistically significant differences between changes in CA 15-3 and CEA after 6 months of chemotherapy and treatment response as assessed by imaging (p<0.001 and p=0.002, respectively). The CA 15-3 level of good responders at 6 months after chemotherapy decreased by 32.3% from the baseline level, while that of poor responders increased by 141.6% from the baseline level, which was statistically significant (p<0.001). The CEA level of good responders at 6 months after chemotherapy decreased by 0.03% from the baseline level, while that of poor responders increased by 182.38% from the baseline level, which was statistically significant (p=0.012).

Conclusions: Our results showed a clear correlation between tumor markers and treatment response as assessed by radiological methods. The use of tumor markers for assessing treatment response has several advantages, including availability, cost savings, and no radiation exposure. Tumor markers can potentially reduce the need for frequent radiological assessments.

Metrics

Metrics Loading ...

Author Biography

Kyaw Swa Mya, Preventive and Social Medicine Department, University of Medicine, Taunggyi

Associate Professor/Head, Department of Biostatistics and Medical Demography

References

Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA: A Cancer Journal for Clinicians. 2023;73(1):17-48.

Gennari A, André F, Barrios CH, Cortés J, de Azambuja E, DeMichele A, et al. ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer. Ann Oncol. 2021;32(12):1475-95.

Sayer HG, Kath R, Kliche KO, Höffken K. Premenopausal breast cancer: chemotherapy and endocrine therapy. Drugs. 2002;62(14):2025-38.

Lee JS, Park S, Park JM, Cho JH, Kim SI, Park BW. Elevated levels of preoperative CA 15-3 and CEA serum levels have independently poor prognostic significance in breast cancer. Annals of Oncology. 2013;24(5):1225-31.

Moazzezy N, Farahany TZ, Oloomi M, Bouzari S. Relationship between Preoperative Serum CA15-3 and CEA Levels and Clinicopathological Parameters in Breast Cancer. Asian Pacific Journal of Cancer Prevention. 2014;15(4):1685–8.

Kabel AM. Tumor markers of breast cancer: New prospectives. Journal of Oncological Sciences. 2017;3(1):5–11.

Geng B, Liang MM, Ye XB, Zhao WY. Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer. Mol Clin Oncol. 2015;3(1):232–6.

Mcguckin M. Prognostic significance of muc1 epithelial mucin expression in breast cancer*1. Human Pathology. 1995;26(4):432–9.

Stähli C, Caravatti M, Aeschbacher M, Kocyba C, Takacs B, Carmann H. Mucin-like carcinoma-associated antigen defined by three monoclonal antibodies against different epitopes. Cancer Res. 1988;48(23):6799–802.

Sokoll LJ, Chan DW. Tumor markers. In: Contemporary Practice in Clinical Chemistry. Elsevier; 2020;779-93.

Budijono R, Haryasena H, Prihantono P, Faruk M. The correlation between value of tumor markers ca 15-3 and cea on histopathology grading, metastasis, disease free-survival and overall survival in women with breast cancer. Int J Surg Med. 2020;(0):1.

Tampellini M, Berruti A, Gorzegno G, Bitossi R, Bottini A, Durando A, et al. Independent factors predict supranormal CA 15-3 serum levels in advanced breast cancer patients at first disease relapse. Tumour Biol. 2001;22(6):367–73.

Anoop TM, Joseph P R, Soman S, Chacko S, Mathew M. Significance of serum carcinoembryonic antigen in metastatic breast cancer patients: A prospective study. World J Clin Oncol. 2022;13(6):529–39.

Stieber P, Nagel D, Blankenburg I, Heinemann V, Untch M, Bauerfeind I, et al. Diagnostic efficacy of CA 15-3 and CEA in the early detection of metastatic breast cancer-A retrospective analysis of kinetics on 743 breast cancer patients. Clin Chim Acta. 2015;448:228–31.

Fu Y, Li H. Assessing Clinical Significance of Serum CA15-3 and Carcinoembryonic Antigen (CEA) Levels in Breast Cancer Patients: A Meta-Analysis. Med Sci Monit. 2016;22:3154–62.

Robertson JF, Pearson D, Price MR, Selby C, Blamey RW, Howell A. Objective measurement of therapeutic response in breast cancer using tumour markers. BJC. 1991;64(4):757–63.

Kurebayashi J, Nishimura R, Tanaka K, Kohno N, Kurosumi M, Moriya T, et al. Significance of serum tumor markers in monitoring advanced breast cancer patients treated with systemic therapy: a prospective study. Breast Cancer. 2004;11(4):389–95.

Robertson JF, Jaeger W, Syzmendera JJ, Selby C, Coleman R, Howell A, et al. The objective measurement of remission and progression in metastatic breast cancer by use of serum tumour markers. European Group for Serum Tumour Markers in Breast Cancer. Eur J Cancer. 1999;35(1):47-53.

Yang Y, Zhang H, Zhang M, Meng Q, Cai L, Zhang Q. Elevation of serum CEA and CA15-3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients. Oncol Lett. 2017;14(6):7549-56.

Laessig D, Nagel D, Heinemann V, Untch M, Kahlert S, Bauerfeind I, Stieber P. Importance of CEA and CA 15-3 during disease progression in metastatic breast cancer patients. Anticancer Res. 2007;27(4A):1963-8.

Di Gioia D, Heinemann V, Nagel D, Untch M, Kahlert S, Bauerfeind I, et al. Kinetics of CEA and CA15-3 correlate with treatment response in patients undergoing chemotherapy for metastatic breast cancer (MBC). Tumor Biol. 2011;32(4):777–85.

Htet-Myat-Han. Clinical study of response to chemotherapy in locally advanced and metastatic breast cancer patients [Master thesis]. Yangon: University of Medicine. 2019;1:131.

Taghizadeh A, Pourali L, Joudi M, Salehi M, Eshghi S, Torabian F, et al. Assessment of elevated serum tumor markers carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) among patients with different subtypes of metastatic breast cancer. Middle East J Cancer. 2019;10(1):17-22.