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. 2011 Jul;284(1):221-7.
doi: 10.1007/s00404-010-1655-2. Epub 2010 Aug 29.

The prognostic and predictive value of CA-125 regression during neoadjuvant chemotherapy for advanced ovarian or primary peritoneal carcinoma

Naveen S Vasudev  1 , Ioannis Trigonis, David A Cairns, Geoff D Hall, David P Jackson, Timothy Broadhead, John Buxton, Richard Hutson, David Nugent, Timothy J Perren
Affiliations

The prognostic and predictive value of CA-125 regression during neoadjuvant chemotherapy for advanced ovarian or primary peritoneal carcinoma

Naveen S Vasudev et al. Arch Gynecol Obstet. 2011 Jul.

Abstract

Purpose: To assess the significance of CA-125 regression as a prognostic indicator and predictor of optimal cytoreduction at interval debulking surgery (IDS) in women with ovarian or primary peritoneal carcinoma receiving neoadjuvant chemotherapy (NAC).

Methods: 63 women treated between 2004 and 2007 with neoadjuvant platinum-based chemotherapy followed by IDS were studied retrospectively. Pre-operative CA-125 values were used to calculate a regression coefficient (CA-125r) using exponential regression analysis. Outcome endpoints were overall survival (OS), time to CA-125 progression (TTC) by Rustin criteria and time to second-line treatment (TTS).

Results: Women with a CA-125 half-life greater than 18 days had a significantly worse OS compared to those with a half-life less than 12 days on univariate testing (HR 3.34, 95% CI 1.25-8.94, p = 0.017). On multivariable analysis, CA-125r was an independent predictor of OS [HR 1.18 (per 0.01 increase in CA-125r), 95% CI 1.01-1.40, p = 0.043]. CA-125r was independently predictive of TTC and TTS (HR 1.17, p ≈ 0.03 for each). CA-125r was also predictive of achieving optimal cytoreduction at IDS (AUC 0.756, p < 0.001).

Conclusions: CA-125 regression rate during pre-operative NAC is of independent prognostic value. CA-125 regression rate strongly predicts for optimal cytoreduction.

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Figures

Figure 1
Figure 1. Regression kinetics for CA-125
A CA-125 values against time for 3 patients with good, average and poor CA-125 response to NAC B Regression curves plotting CA-125 (y-axis (log-scale)) against time (x-axis) from starting NAC C Regression co-efficients
Figure 2
Figure 2. Kaplan Meier curves based on CA-125r
CA-125r was considered as tertiles in all cases. A Overall survival B Time to second line treatment C Time to CA-125 progression
See this image and copyright information in PMC

References

    1. Tangjitgamol S, Manusirivithaya S, Laopaiboon M, et al. Interval debulking surgery for advanced epithelial ovarian cancer: a Cochrane systematic review. Gynecol Oncol. 2009;112:257–264. - PubMed
    1. Kang S, Nam BH. Does Neoadjuvant Chemotherapy Increase Optimal Cytoreduction Rate in Advanced Ovarian Cancer? Meta-Analysis of 21 Studies. Ann Surg Oncol. 2009;16:2315–2320. - PubMed
    1. Vergote I, Trope CG, Amant F. EORTC-GCG/NCIC-CTG randomized trial comparing primary debulking surgery with neoadjuvant chemotherapy in stage IIIC-IV ovarian, fallopian tube and peritoneal cancer; Plenary presentation at the 12th Biennial meeting International Gynecologic Cancer Society IGCS; Bangkok, Thailand. 2008.
    1. Rustin GJ, Nelstrop AE, McClean P, et al. Defining response of ovarian carcinoma to initial chemotherapy according to serum CA 125. J Clin Oncol. 1996;14:1545–1551. - PubMed
    1. Riedinger JM, Eche N, Basuyau JP, et al. Prognostic value of serum CA 125 bi-exponential decrease during first line paclitaxel/platinum chemotherapy: a French multicentric study. Gynecol Oncol. 2008;109:194–198. - PubMed

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