Was Abraxane not effective for me if my tumor marker is still high?

A fellow caregiver asked...

I have been taking Abraxane on a three week interval at a dose of 395 mg.  When I started it, my tumor marker was about 380 but now after the ninth course it is still high at 130.  Does this mean that Abraxane was not effective for me?

Expert Answer

Ernest Rosenbaum, MD, is an oncologist affiliated with Stanford University and with the Comprehensive Cancer Center at the University of California, San Francisco, where he has developed protocols for supportive care and clinical practices.

Abraxane is a new form of paclitaxel made with human protein that has been found to be effective in fighting metastatic breast cancer. Your doctor has prescribed this chemotherapy to control the spread of the disease, and uses serum tumor markers to measure the levels of certain proteins and other substances in your blood. So far you've reduced your tumor markers by almost two thirds, so this indicates that the cancer is responsive to the drug. However, it's important to note that the use of tumor markers to monitor the progression of metastatic breast cancer is controversial, because tumor marker levels haven't always been found to correlate with treatment outcome and survival rates. Still, oncologists generally agree that a rising tumor marker level likely means treatment is not working, while a falling level suggests treatment is effective.

You need to talk with your doctor and ask her to be quite clear and open about the stage and prognosis of your cancer, and what results you might be able to expect from the chemotherapy. In general when Abraxane is prescribed for metastatic breast cancer, it's at a point where the chemotherapy is intended to control the spread of the cancer, but is not capable of curing the disease altogether. Ask your doctor to go over your test results in detail and explain what you're seeing, what she hoped to see, and what kinds of results you can hope for over the course of treatment.