Thrombotic biomarkers for risk prediction of malignant disease recurrence in patients with early stage breast cancer.

Autor:	Giaccherini C; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Marchetti M; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Masci G; Oncology Unit, IRCCS Humanitas Institute, Rozzano., Verzeroli C; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Russo L; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Celio L; Oncology Unit, IRCCS National Cancer Institute, Milan., Sarmiento R; Oncology Unit, Hospital San Filippo Neri, Rome., Gamba S; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Tartari CJ; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Diani E; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Vignoli A; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo., Malighetti P; Department of Management, Information and Production Engineering, University of Bergamo, Bergamo., Spinelli D; Department of Management, Information and Production Engineering, University of Bergamo, Bergamo., Tondini C; Oncology Unit, Hospital Papa Giovanni XXIII, Bergamo., Barni S; Oncology Unit, Hospital Treviglio-Caravaggio, Treviglio., Giuliani F; Oncology Unit, IRCCS Cancer Institute Giovanni Paolo II, Bari., Petrelli F; Oncology Unit, Hospital Treviglio-Caravaggio, Treviglio., D'Alessio A; Medical Oncology and Internal Medicine, Policlinico San Marco, Zingonia-Bergamo., Gasparini G; Oncology Unit, Hospital San Filippo Neri, Rome., De Braud F; Oncology Unit, IRCCS National Cancer Institute, Milan., Santoro A; Oncology Unit, IRCCS Humanitas Institute, Rozzano., Labianca R; Department Oncology Bergamo Province, Hospital Papa Giovanni XXIII, Bergamo., Falanga A; Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo annafalanga@yahoo.com.; University of Milan Bicocca, School of Medicine and Surgery, Milan, Italy.
Jazyk:	angličtina
Zdroj:	Haematologica [Haematologica] 2020 Jun; Vol. 105 (6), pp. 1704-1711. Date of Electronic Publication: 2019 Sep 26.
DOI:	10.3324/haematol.2019.228981
Abstrakt:	In cancer patients, hypercoagulability is a common finding. It has been associated with an increased risk of venous thromboembolism, but also to tumor proliferation and progression. In this prospective study of a large cohort of breast cancer patients, we aimed to evaluate whether pre-chemotherapy abnormalities in hemostatic biomarkers levels: (i) are associated with breast cancer-specific clinico-pathological features; and (ii) can predict for disease recurrence. D-dimer, fibrinogen, prothrombin fragment 1+2, and FVIIa/antithrombin levels were measured in 701 early-stage resected breast cancer patients candidate to adjuvant chemotherapy and prospectively enrolled in the HYPERCAN study. Significant prognostic parameters for disease recurrence were identified by Cox regression multivariate analysis and used for generating a risk assessment model. Pre-chemotherapy D-dimer, fibrinogen, and pro-thrombin fragment 1+2 levels were significantly associated with tumor size and lymph node metastasis. After 3.4 years of follow up, 71 patients experienced a recurrence. Cox multivariate analysis identified prothrombin fragment 1+2, tumor size, and Luminal B HER2-negative or triple negative molecular subtypes as independent risk factors for disease recurrence. Based on these variables, we generated a risk assessment model that significantly differentiated patients at low- and high-risk of recurrence (cumulative incidence: 6.2 vs 20.7%; Hazard Ratio=3.5; P <0.001). Our prospective clinical and laboratory data from the HYPERCAN study were crucial for generating a scoring model for assessing risk of disease recurrence in resected breast cancer patients, candidate to systemic chemotherapy. This finding stimulates future investigations addressing the role of plasma prothrombin fragment 1+2 in the management of breast cancer patients to provide the rationale for new therapeutic strategies. (The HYPERCAN study is registered at clinicaltrials.gov identifier 02622815 ). (Copyright© 2020 Ferrata Storti Foundation.)
Databáze:	MEDLINE
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