Coleman, R.E. orcid.org/0000-0002-4275-1043, Whitaker, K.B., Moss, D.W. et al. (3 more authors) (1988) Biochemical prediction of response of bone metastases to treatment. British Journal of Cancer, 58 (2). pp. 205-210. ISSN 0007-0920
Abstract
Assessment of response of skeletal metastases to systemic therapy is currently dependent on radiological evidence of bone healing. We have performed a prospective study of additional response criteria in patients with progressive bone metastases from breast cancer. Changes in these potential markers of response were correlated with the radiological response and the time to treatment failure (TTF). Successful systemic therapy typically led to a transient increase in osteoblast activity ('flare'), a reduction in osteoclast activity and symptomatic improvement. After 1 month a greater than 10% rise in serum osteocalcin (BGP) and alkaline phosphatase bone isoenzyme (ALP-BI) and a greater than 10% fall in urinary calcium excretion were seen in 14/16 patients with radiographic evidence of bone healing (UICC partial responders). In comparison similar biochemical changes at 1 month were seen in only 4/20 patients with progressive disease (P less than 0.001). The predictive value and diagnostic efficiency (DE) of changes at 1 month in biochemical measurements and symptom score has been calculated. The combination of a greater than 10% rise in ALPBI and BGP and a greater than 10% fall in urinary calcium excretion had a DE of 89% for discriminating response from progression, 88% for response from non-response (progressing + no change patients), and 76% for TTF of greater than 6 months from TTF of less than 6 months. Serum calcium, tartrate resistant acid phosphatase (TRP), urinary hydroxyproline excretion and bone scan changes were unhelpful in discriminating between patient groups. Independent confirmation is needed, but our results suggest there are reliable alternatives to plain radiography in the early assessment of response of bone metastases to treatment.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 1988 The Macmillan Press Ltd. |
Keywords: | Adult; Aged; Aged, 80 and over; Alkaline Phosphatase; Bone Neoplasms; Bone and Bones; Breast Neoplasms; Calcium; Calcium-Binding Proteins; Female; Humans; Isoenzymes; Middle Aged; Osteoblasts; Osteocalcin; Osteoclasts; Prospective Studies; Radiography |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Sheffield Teaching Hospitals |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 15 Feb 2021 11:59 |
Last Modified: | 15 Feb 2021 11:59 |
Status: | Published |
Publisher: | Springer Nature (for Cancer Research UK) |
Refereed: | Yes |
Identification Number: | 10.1038/bjc.1988.194 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:170588 |