التفاصيل البيبلوغرافية
| العنوان: |
Associations Between Serum Bone Biomarkers in Early Breast Cancer and Development of Bone Metastasis: Results From the AZURE (BIG01/04) Trial. |
| المؤلفون: |
Brown, Janet1 j.e.brown@sheffield.ac.uk, Rathbone, Emma2, Hinsley, Samantha3, Gregory, Walter3, Gossiel, Fatma4, Marshall, Helen3, Burkinshaw, Roger5, Shulver, Helen5, Thandar, Hasina6, Bertelli, Gianfilippo7, Maccon, Keane8 (AUTHOR), Bowman, Angela9 (AUTHOR), Hanby, Andrew10 (AUTHOR), Bell, Richard11 (AUTHOR), Cameron, David9 (AUTHOR), Coleman, Robert5 (AUTHOR) |
| المصدر: |
JNCI: Journal of the National Cancer Institute. Aug2018, Vol. 110 Issue 8, p871-879. 9p. 3 Charts, 4 Graphs. |
| مصطلحات موضوعية: |
*BREAST cancer treatment, *ADJUVANT treatment of cancer, *BONE metastasis, *BREAST cancer, *BONE cancer, *PREVENTION, *BONE metabolism, *BONE remodeling, *BONE growth, *BONE tumors, *BREAST tumors, *COMBINED modality therapy, *COMPARATIVE studies, *INTRAVENOUS therapy, *RESEARCH methodology, *MEDICAL quality control, *MEDICAL cooperation, *PROGNOSIS, *RESEARCH, *RESEARCH funding, *EVALUATION research, *DISEASE progression, *EARLY detection of cancer |
| مستخلص: |
Background: Adjuvant therapies can prevent/delay bone metastasis development in breast cancer. We investigated whether serum bone turnover markers in early disease have clinical utility in identifying patients with a high risk of developing bone metastasis.Methods: Markers of bone formation (N-terminal propeptide of type-1 collagen [P1NP]) and bone resorption (C-telopeptide of type-1 collagen [CTX], pyridinoline cross-linked carboxy-terminal telopeptide of type-1 collagen [1-CTP]) were measured in baseline (pretreatment blood samples from 872 patients from a large randomized trial of adjuvant zoledronic acid (AZURE-ISRCTN79831382) in early breast cancer. Cox proportional hazards regression and cumulative incidence functions (adjusted for factors having a statistically significant effect on outcome) were used to investigate prognostic and predictive associations between recurrence events, bone marker levels, and clinical variables. All statistical tests were two-sided.Results: When considered as continuous variables (log transformed), P1NP, CTX, and 1-CTP were each prognostic for future bone recurrence at any time (P = .006, P = .009, P = .008, respectively). Harrell's c-indices were a P1NP of 0.57 (95% confidence interval [CI] = 0.51 to 0.63), CTX of 0.57 (95% CI = 0.51 to 0.62), and 1-CTP of 0.57 (95% CI = 0.52 to 0.63). In categorical analyses based on the normal range, high baseline P1NP (>70 ng/mL) and CTX (>0.299 ng/mL), but not 1-CTP (>4.2 ng/mL), were also prognostic for future bone recurrence (P = .03, P = .03, P = .10, respectively). None of the markers were prognostic for overall distant recurrence; that is, they were bone metastasis specific, and none of the markers were predictive of treatment benefit from zoledronic acid.Conclusions: Serum P1NP, CTX, and 1-CTP are clinically useful, easily measured markers that show good prognostic ability (though low-to-moderate discrimination) for bone-specific recurrence and are worthy of further study. [ABSTRACT FROM AUTHOR] |
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