Serum Caspase-3 and Caspase-7 as Predictive Factors of Response in Locally Advanced and Metastatic Breast Carcinoma

Introduction: Breast cancer is the most common cancer in women and the second most frequent cause of cancer death. Several factors affect response to chemotherapy including nodal status, hormonal status and human epidermal growth factor receptor (Her-2). Aim of Study: The study is aiming at evaluating Caspase-3, 7 levels in serum of patients with locally advanced and metastatic breast cancer and establishing the relation between Casepase level and response to chemotherapy. Patients and Methods: The study was performed at Al Bairouni University Hospital and the Faculty of Pharmacy (Damascus-Syria). We have included 60 patients with histologic confirmation of in- vasive ductal carcinoma of the breast treated with the combination (Docetaxel + Doxorubicin) with Caspase-3, 7 levels to be evaluated before treatment and 24 hours after the first and third cy- cle. Results: Caspase-3 level increases in serum 24 hours after the 1st cycle correlated with differ- ent kinds of response in 39 patients (P value 0.0002) with better results in those with Estrogen Receptors (ER) positive patients (P 0.005). In a similar manner, Caspase-7 level increases 24 hours after the 1st cycle correlated with response in 40 patients (P 0.005). However, ER status had no impact on response in Caspase-7 group (P 0.2). Conclusion: Caspase-3 and 7 levels in serum are useful as a predictive marker of response to chemotherapy in both locally advanced and metas- tatic breast cancer especially when tittered 24 hours after the first chemotherapy.