SERUM MARKERS OF BONE METASTASES IN POSTMENOPAUSAL BREAST-CANCER PATIENTS TREATED WITH FORMESTANE

Bone metabolism marker evaluation is expected to play an auxiliary rol e in the diagnosis and follow-up of bone metastases in patients affect ed by different types of neoplasms, In this study we have evaluated os teoblastic and osteoclastic markers in 18 patients with bone metastase s from breast cancer at diagnosis and for 1 year of follow-up during t reatment with the aromatase inhibitor formestane. Osteoblastic markers include the carboxy-terminal propeptide of type I procollagen, the bo ne-specific alkaline phosphatase and the bone GLA protein, The carboxy -terminal cross-linked telopeptide of type I collagen (ICTP) was evalu ated as a marker of osteoclastic activity, The patients were classifie d into three groups according to clinical response. A good correlation between marker level modifications and clinical evolution of skeletal metastases was observed for all the examined markers. Patients with p rogressive disease showed increasing levels of all markers, whereas pa tients in regression showed a reduction compared to the basal levels; patients with stable disease fell in between these two categories, We also found that basal ICTP values have prognostic significance: in the stable and progressive disease group they were higher than in the par tial response group.