Falsely elevated serum oestradiol due to exemestane therapy

Ann Clin Biochem. 2017 May;54(3):402-405. doi: 10.1177/0004563216674031. Epub 2016 Sep 28.

Abstract

In this study, we present a case of falsely elevated oestradiol (E2) concentration, determined by two immunoassays, in a breast cancer patient receiving exemestane therapy. The positive bias of immunochemical measurements was revealed using liquid chromatography tandem mass spectrometry which showed undetectable E2 concentration. The discrepancy is expected to be a consequence of the structural resemblance of E2 and exemestane sharing the same steroidal backbone. Inaccurate laboratory findings in therapy monitoring, as in this case, may lead to unnecessary changes of therapy.

Keywords: Immunoassay; mass spectrometry; steroid hormones.

Publication types

  • Case Reports

MeSH terms

  • Androstadienes / blood*
  • Androstadienes / therapeutic use
  • Antineoplastic Agents / blood*
  • Antineoplastic Agents / therapeutic use
  • Aromatase Inhibitors / blood*
  • Aromatase Inhibitors / therapeutic use
  • Breast Neoplasms / blood
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Contraindications
  • Drug Dosage Calculations
  • Estradiol / blood*
  • False Positive Reactions
  • Female
  • Humans
  • Immunoassay*
  • Middle Aged
  • Molecular Mimicry
  • Monitoring, Physiologic

Substances

  • Androstadienes
  • Antineoplastic Agents
  • Aromatase Inhibitors
  • Estradiol
  • exemestane