Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2014 Mar;132(3):560-5.
doi: 10.1016/j.ygyno.2013.11.016. Epub 2013 Dec 13.

The prognostic significance of pre- and post-treatment CA-125 in grade 1 serous ovarian carcinoma: a gynecologic Oncology Group study

Amanda Nickles Fader  1 , James Java  2 , Thomas C Krivak  3 , Robert E Bristow  4 , Ana I Tergas  5 , Michael A Bookman  6 , Deborah K Armstrong  5 , Edward J Tanner  5 , David M Gershenson  7
Affiliations
Clinical Trial

The prognostic significance of pre- and post-treatment CA-125 in grade 1 serous ovarian carcinoma: a gynecologic Oncology Group study

Amanda Nickles Fader et al. Gynecol Oncol. 2014 Mar.

Abstract

Objectives: The study objective was to determine the prognostic significance of serum CA-125 levels in patients with grade 1 serous ovarian carcinoma (SOC) enrolled in a Phase III study.

Methods: An ancillary analysis of a phase III study of women with advanced epithelial ovarian cancer treated with carboplatin/paclitaxel versus triplet or sequential doublet regimens. Grade 1 SOC was used as a surrogate for low-grade serous carcinoma.

Results: Among 3686 enrolled patients, 184 (5%) had grade 1 disease and CA-125 levels available. For those with grade 1 SOC, the median patient age was 56.5; 87.3% had Stage III disease. Median follow-up was 102 months and there was no difference in pre-chemotherapy CA-125 by treatment arm (P=0.91). Median pretreatment CA-125 for those with grade 1 SOC was lower (119.1) than for patients with grade 2-3 SOC (246.7; P<0.001). In those with grade 1, pretreatment CA-125 was not prognostic of outcome. However, patients with CA-125 levels that normalized after cycle 1, 2 or 3 were 60-64% less likely to experience disease progression as compared to those who never normalized or normalized after 4 cycles (P ≤ 0.024). Normalization of CA-125 levels before the second cycle was negatively associated with death, with a HR of 0.45 (P=0.025).

Conclusions: Pretreatment CA-125 level was significantly lower in women with grade 1 SOC compared to those with high-grade SOC. While pretreatment CA-125 was not associated with survival, serial CA-125 measurements during chemotherapy treatment were prognostic, with normalization before the second chemotherapy cycle associated with a decreased risk of death.

Keywords: CA-125; Low grade serous carcinoma; Ovarian cancer.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Median CA-125 (U/mL) by chemotherapy cycle and residual disease status.
Fig. 2
Fig. 2
Patients’ (N = 184) peak CA-125 values by the cycle when they occurred.
Fig. 3
Fig. 3
Overall survival based on CA-125 normalization during chemotherapy treatment.
See this image and copyright information in PMC

References

    1. Bast RC, Jr, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest. 1981;68:1331–7. - PMC - PubMed
    1. Yin BW, Lloyd KO. Molecular cloning of the CA125 ovarian cancer antigen: identification as a new mucin, MUC16. J Biol Chem. 2001;20:27371–5. - PubMed
    1. Bast RC, Jr, Klug TL, St. John E, Jenison E, Niloff JM, Lazarus H, et al. A radioimmuno-assay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. N Engl J Med. 1983;309:883–7. - PubMed
    1. Jacobs I, Bast RC., Jr The CA 125 tumour-associated antigen: a review of the literature. Hum Reprod. 1989;4:1–12. - PubMed
    1. Zorn KK, Tian C, McGuire WP, Hoskins WJ, Markman M, Muggia FM, et al. Prognostic value of pretreatment CA-125 in advanced ovarian carcinoma: a Gynecologic Oncology Group study. Cancer. 2009;115:1028–35. - PMC - PubMed

Publication types

MeSH terms