New Test Predicts Node-negative Breast Cancer Metastases

April 4, 2000

DG DISPATCH - AACR: New Test Predicts Node-negative Breast Cancer Metastases

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By Susman

Special to DG News

SAN FRANCISCO, CA -- April 4, 2000 -- German researchers report that testing for

two molecular markers associated with tumor invasion helps predict which women

should undergo chemotherapy for node-negative breast cancer.

Anita Prechtl, MD, professor of obstetrics and gynecology at Munich's Technical

University, in Germany, said the results of her study are already being applied

clinically in her country. Her study was halted prematurely by the safety and

monitoring board because treatment groups were faring better than the

observation groups.

At the 91st annual meeting of the American Association for Cancer Research

(AACR), Prechtl said breast cancer recurs in about 30 percent of node-negative

women.

Now the doctors dilemma of who needs adjuvant chemotherapy has been eased, Dr.

Prechtl said, by testing for levels of two prognostic markers: urokinase-type

plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1).

The two factors are linked to tumor invasion and spread of the disease, she

said.

Dr. Prechtl's study showed that women with low levels of uPA and PAI-1 had a 95

percent probability of being free of disease after five years. Women with high

levels of uPA and PAI-1 had a 65 percent chance of being disease-free after five

years.

Dr. Prechtl also studied whether use of a common chemotherapy regimen would

affect outcomes in women with high uPA and PAI-1 readings. Half the women with

high reading received chemotherapy; the others were observed.

The safety monitoring board halted the study after it found that the risk of

cancer recurring in those receiving chemotherapy was 12 percent, and in those

not receiving chemotherapy it was 18 percent.

" Those figures represented a trend toward significance, " Dr. Prechtl said.

" The data are quite compelling, " said Arteaga, MD, professor of medicine

and cell biology at Vanderbilt University, in Nashville, TN.

While not reaching statistical significance, Dr. Arteaga said the difference was

strong enough to force the monitoring board to act. " We expect that those cancer

recurrence rates will continue to widen in time, " he said.

He added that acceptance of the testing for uPA and PAI-1 in the United States

will have to wait until ongoing studies are completed. " There are a huge number

of women in this group, " he said " But we don't use this test yet in the United

States. "

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