However, the specificity might be low due to induction of GRP78 in other stress settings, such as pulmonary arterial hypertension,[7] rheumatoid arthritis,[27, 28, 29] obesity and metabolic syndrome,[30, 31] as well as other types of tumors.[5] In our investigation, it was also observed that serum sGRP78 was significantly elevated in breast cancer patients receiving neoadjuvant therapy, especially after 4th round of chemotherapy (quantified as “sGRP78 index”). This evidence concerns the gene HSPA5 and obesity due to melanocortin 4 receptor deficiency.