Abstract
Background & Objective:Prediction of response to neoadjuvant treatment is an important part of treatment of patients with breast cancer. This study aimed to assess changes in serum levels of Cytokeratin 18 during neoadjuvant chemotherapy in patients with locally advanced breast cancer and its association with neoadjuvant treatments. Methods:This research was performed on newly diagnosed breast cancer patients referred to Omid Radiotherapy Center and radiotherapy and oncology departments of Emam Reza and Ghaem hospitals, in Mashhad, Iran. Serum levels of M30 and M65 fragments of Cytokeratin 18 were measured before and 24 hours after the first course of neoadjuvant chemotherapy. Changes in serum levels of Cytokeratin 18 and its fragments and their correlation with pathologic response were analyzed.Results:Pre- and post-chemotherapy levels of M30 were respectively 223.9±18.94 and 250.7±23.92 U/L (P=0.24). For M65, these levels were respectively 301.5±313.9 and 330.2±352.2 U/L (P=0.1). Changes in M30 level during chemotherapy in patients with and without pathologic complete response were -20±92.69 and 43.1±106.5, respectively (P=0.1). For M65, these changes were respectively -247±55 and 76±240 (P=0.1). Baseline levels of M30 and M65 had no relation with menopausal status, tumor grade, hormone receptor status, Ki67 expression, molecular subtype, and stage. Conclusion:Our findings showed statistically insignificant changes in the level of Caspase-cleaved- (M30) and uncleaved- (M65) cytokeratin 18 fragments (apoptotic and necrotic indicators, respectively) during neoadjuvant chemotherapy in patients with breast cancer. There was no notable relationship between tumor-related factors and either baseline levels or serum changes of CK18 fragments. Also, there was no correlation between M30/M65 level and pathologic response to neoadjuvant chemotherapy.
Highlights
Breast cancer is one of the most commonly diagnosed neoplasms in women [1,2]
Research has shown that patients whose primary tumor exhibits a pathologic complete response to neoadjuvant treatment generally have better treatment outcomes and survival rates [4]
The assessment of M30 level in different molecular subtypes showed that before treatment the patients with triple negative breast cancer had the highest level of M30 and the patients with luminal A cancer had the highest level of M65
Summary
Remarkable progress in systemic chemotherapy, hormone therapy, and targeted therapy has significantly reduced the mortality of stage I, II, and III breast cancer patients. Neoadjuvant chemotherapy treatment is widely accepted as a standard treatment for locally advanced and inflammatory breast cancers. Assessment of response to neoadjuvant treatment is of paramount importance for preventing excess toxicity in patients who do not benefit from chemotherapy. For most patients, this assessment only involves clinical. Prediction of response to neoadjuvant treatment is an important part of treatment of patients with breast cancer. This study aimed to assess changes in serum levels of Cytokeratin 18 during neoadjuvant chemotherapy in patients with locally advanced breast cancer and its association with neoadjuvant treatments
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