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Clinical Trial
. 2009 Oct;115(1):81-85.
doi: 10.1016/j.ygyno.2009.06.021. Epub 2009 Jul 12.

A Gynecologic Oncology Group Study of serum CA-125 levels in patients with stage III optimally debulked ovarian cancer treated with intraperitoneal compared to intravenous chemotherapy: an analysis of patients enrolled in GOG 172

Thomas C Krivak  1 , Chunqiao Tian  2 , G Scott Rose  3 , Deborah K Armstrong  4 , G Larry Maxwell  3
Affiliations
Clinical Trial

A Gynecologic Oncology Group Study of serum CA-125 levels in patients with stage III optimally debulked ovarian cancer treated with intraperitoneal compared to intravenous chemotherapy: an analysis of patients enrolled in GOG 172

Thomas C Krivak et al. Gynecol Oncol. 2009 Oct.

Abstract

Objective: Serum CA-125 values have been advocated in the monitoring of ovarian cancer patients receiving intravenous (IV) chemotherapy. This evaluation sought to determine if the CA-125 test can be used to monitor treatment effect among patients receiving intraperitoneal chemotherapy (IP).

Methods: Patient charts from a phase III clinical trial (GOG 172) were retrospectively reviewed. Serum CA-125 levels prior to each cycle of therapy were collected and compared between the IV and IP chemotherapy delivery. The association between CA-125 and progression-free survival (PFS) or overall survival (OS) was estimated and the homogeneity of the results between IP and IV chemotherapy was assessed.

Results: A total of 177 patients were treated with IV chemotherapy and 165 patients with IP chemotherapy with CA-125 data available were included in this analysis. The observed difference was not statistically significant in median CA-125 levels between the IV and IP arms at any time point (P>0.05 for all). Following surgery and adjuvant chemotherapy, patients with an abnormal CA-125 >35 U/ml were 2.45 times more likely to have disease progression (95% CI: 1.52-3.95, P<0.001) and 2.78 times more likely to die of disease (95% CI: 1.66-4.65, P<0.001), compared to those with a CA-125 <35 U/ml. These results were consistent with IP and IV chemotherapy.

Conclusion: Serum CA-125 levels decrease in a similar manner during IP chemotherapy when compared to IV chemotherapy. Serum CA-125 algorithms for monitoring treatment effect that have been established for IV chemotherapy may also be applied for patients receiving IP chemotherapy.

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Conflict of interest statement

Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Fig. 1
Fig. 1
CA-125 changes following intravenous (IV) and intraperitoneal (IP) chemotherapy.
Fig. 2
Fig. 2
(A) Kaplan–Meier estimate of progression-free survival based on normalization of CA-125 at end of chemotherapy for IV versus IP treatment. (B) Kaplan–Meier estimate of overall survival based on normalization of CA-125 at end of chemotherapy for IV versus IP treatment.
See this image and copyright information in PMC

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