Relationship of serum M30 and M65 levels with clinical andpatological prognostic parameters and predictive valuein neoadjuvan chemotherapy of breast cancer patients

Introduction-Purpose: It is important that the neoadjuvant chemotherapy response of locally advanced breast cancer patients can be predicted. Apoptotic marker M30 and apoptotic and necrosis marker M65 levels, which are cytoskeletal elements of cytokeratin 18 , reflects tumor cell activity by epithelial cancer patients. The aim of our study is to investigate the relation and prognostic value of M30, M65 and M65-30 (Necrosis) levels with prognostic criteria in neoadjuvant treatment of breast cancer. Materials and Methods: Fourty-one patients with a mean age of 46.2 (28-67) with breast cancer who underwent neoadjuvant chemotherapy were included to this prospective study. Patients received paclitaxel treatment for 12 weeks following chemotherapy with the first 4 cycles of anthracycline (FEC, AC or EC). Blood samples were collected before treatment (0) and 21 days after the 2nd, 4th, and 8th cycles. M30 and M65 levels were measured by ELISA. Findings: The increase in M30 and M65 levels were significant between cycles (p <0.05), but no significant correlation was found in the distribution of M65-30. There was a significant increase in M30 and M65 in first four cycles, and a decrease in 8th cycle was observed. M30, M65 and M65-30 levels were compared with ER, PR, c-Erb-2, Ki-67, pathological-T, pathologic-N and chemotherapy responses and only significant correlation (P = 0.04) was found between M65 and pathologic-N. Conclusion: In our study, M30 and M65 levels were significantly increased in first four cycles, when patients received anthracycline-containing chemotherapy and significantly decreased after paclitaxel chemotherapy, so after 8th cycle. There were no relationship between ER, PR, c-Erb-2, Ki-67, pathologic-T, pathologic-N and treatment response. More extensive studies are needed to assess the predictive and prognostic value of M30 and M65. Key words: Breast cancer, M30, M65, neoadjuvant chemotherapy