Main Article Content

Abstract

Background: There are several ways to treat breast cancer, one of which is administering chemotherapy agents. Chemotherapy agents have activity in inhibiting the cell cycle. That will affect the effectiveness of therapy and the side effects of chemotherapy agents.


Objective: This study aimed to evaluate single and combination chemotherapy agent therapeutic efficacy and side effects


Method: The design of this study used an observational cohort study with retrospective data collection from January to December 2019. Patients obtained from medical records were diagnosed with metastatic stage of breast cancer at Panti Nirmala Hospital, Malang. The effectiveness of the chemotherapy agent was seen from the carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3), which were carried out in the first and third cycles, then analyzed using the Wilcoxon and U-Mann Whitney tests. Side effects of chemotherapy agents were analyzed descriptively.


Results: Analysis of the Wilcoxon test showed differences between the two groups of chemotherapeutic agents in CEA and CA15-3 (p<0.05). U-Mann Whitney test analysis showed no difference after administration of the two groups of chemotherapy agents at CEA (p>0.05). However, there was a difference in CA15-3 (p<0.05). Both chemotherapy agents showed most common side effects such as pain, nausea,  vomiting, and alopecia.


Conclusion: Patients who received a combination of chemotherapy agents had lower CA15-3 levels than single chemotherapy agents.

Keywords

Metastatic breast cancer CEA CA15-3 chemotherapy agents

Article Details

References

  1. Antonarakis, E. S., & Hain, R. D. (2004). Nausea and vomiting associated with cancer chemotherapy: drug management in theory and in practice. Arch Dis Child, 89(9), 877-880. https://doi.org/10.1136/adc.2003.037341
  2. Chan, H. K., & Ismail, S. (2014). Side effects of chemotherapy among cancer patients in a Malaysian General Hospital: experiences, perceptions and informational needs from clinical pharmacists. Asian Pac J Cancer Prev, 15(13), 5305-5309. https://doi.org/10.7314/apjcp.2014.15.13.5305
  3. Geng, B., Liang, M. M., Ye, X. B., & Zhao, W. Y. (2015). Association of CA 15-3 and CEA with clinicopathological parameters in patients with metastatic breast cancer. Mol Clin Oncol, 3(1), 232-236. https://doi.org/10.3892/mco.2014.419
  4. Haslam, I. S., & Smart, E. (2019). Chemotherapy-Induced Hair Loss: The Use of Biomarkers for Predicting Alopecic Severity and Treatment Efficacy. Biomark Insights, 14, 1177271919842180. https://doi.org/10.1177/1177271919842180
  5. Hosseini, S. M., Razmjoo, S., Arvandi, S. H., & Barat, T. (2015). CEA and CA 15-3 serum level in metastatic breast cancer and its correlation with distant metastasis Biomedical and Pharmacology Journal, 8, 721–727. https://doi.org/https://doi.org/10.13005/bpj/775
  6. Kabel, A. (2017). Tumor markers of breast cancer: New prospectives. Journal of Oncological Sciences, 3. https://doi.org/10.1016/j.jons.2017.01.001
  7. Kemenkes. (2019). Panduan Penatalaksanaan Kanker Payudara (Breast Cancer Treatment Guideline). Jurnal Kesehatan Masyarakat 4(4), 1-50. http://kanker.kemkes.go.id/guidelines/PPKPayudara.pdf
  8. McDonald, E. S., Clark, A. S., Tchou, J., Zhang, P., & Freedman, G. M. (2016). Clinical Diagnosis and Management of Breast Cancer. J Nucl Med, 57 Suppl 1, 9s-16s. https://doi.org/10.2967/jnumed.115.157834
  9. Rossi, A., Fortuna, M. C., Caro, G., Pranteda, G., Garelli, V., Pompili, U., & Carlesimo, M. (2017). Chemotherapy-induced alopecia management: Clinical experience and practical advice. J Cosmet Dermatol, 16(4), 537-541. https://doi.org/10.1111/jocd.12308
  10. Singh, P., Yoon, S. S., & Kuo, B. (2016). Nausea: a review of pathophysiology and therapeutics. Therap Adv Gastroenterol, 9(1), 98-112. https://doi.org/10.1177/1756283x15618131
  11. Yang, Y., Zhang, H., Zhang, M., Meng, Q., Cai, L., & Zhang, Q. (2017). Elevation of serum CEA and CA15-3 levels during antitumor therapy predicts poor therapeutic response in advanced breast cancer patients. Oncol Lett, 14(6), 7549-7556. https://doi.org/10.3892/ol.2017.7164
  12. Zajączkowska, R., Kocot-Kępska, M., Leppert, W., Wrzosek, A., Mika, J., & Wordliczek, J. (2019). Mechanisms of Chemotherapy-Induced Peripheral Neuropathy. Int J Mol Sci, 20(6). https://doi.org/10.3390/ijms20061451