PURPOSE: To determine an accurate definition for progression of ovarian cancer in patients with a persistently elevated serum CA-125. PATIENTS AND METHODS: A retrospective analysis was performed on 300 patients with epithelial ovarian carcinoma with at least one measurement of CA-125. The date of progression according to clinical or radiologic criteria was ascertained in the 88 patients with persistently elevated CA-125 levels (> 23 U/mL). This was compared with the date of progression according to CA-125, defined as the date on which the CA-125 level first increased to >or= twice its nadir level, confirmed by a second sample also >or= twice the nadir. RESULTS: Eighty of the 88 patients had evidence of progression by both standard and CA-125 criteria, giving a sensitivity of 94%. In six of these patients, no sample was taken to confirm CA-125 doubling. In 13 patients, CA-125 doubling occurred after the date of clinical progression. Only one patient had a false-positive prediction of progression according to CA-125; the patient died as a result of a myocardial infarct before evidence of clinical progression. CONCLUSION: In patients whose CA-125 level decreases to normal after chemotherapy, a doubling from the upper limit of normal has been shown to predict progression. In those with persistently elevated levels, doubling of CA-125 from its nadir level has now been shown to accurately define progression. If confirmed, these CA-125 criteria should be used as additional end points in clinical trials.
PURPOSE: To determine an accurate definition for progression of ovarian cancer in patients with a persistently elevated serum CA-125. PATIENTS AND METHODS: A retrospective analysis was performed on 300 patients with epithelial ovarian carcinoma with at least one measurement of CA-125. The date of progression according to clinical or radiologic criteria was ascertained in the 88 patients with persistently elevated CA-125 levels (> 23 U/mL). This was compared with the date of progression according to CA-125, defined as the date on which the CA-125 level first increased to >or= twice its nadir level, confirmed by a second sample also >or= twice the nadir. RESULTS: Eighty of the 88 patients had evidence of progression by both standard and CA-125 criteria, giving a sensitivity of 94%. In six of these patients, no sample was taken to confirm CA-125 doubling. In 13 patients, CA-125 doubling occurred after the date of clinical progression. Only one patient had a false-positive prediction of progression according to CA-125; the patient died as a result of a myocardial infarct before evidence of clinical progression. CONCLUSION: In patients whose CA-125 level decreases to normal after chemotherapy, a doubling from the upper limit of normal has been shown to predict progression. In those with persistently elevated levels, doubling of CA-125 from its nadir level has now been shown to accurately define progression. If confirmed, these CA-125 criteria should be used as additional end points in clinical trials.
Authors: Rudy S Suidan; Qin Zhou; Alexia Iasonos; Roisin E O'Cearbhaill; Dennis S Chi; Kara C Long Roche; Edward J Tanner; John Denesopolis; Richard R Barakat; Oliver Zivanovic Journal: Int J Gynecol Cancer Date: 2015-05 Impact factor: 3.437
Authors: Rudy S Suidan; Mario M Leitao; Oliver Zivanovic; Ginger J Gardner; Kara C Long Roche; Yukio Sonoda; Douglas A Levine; Elizabeth L Jewell; Carol L Brown; Nadeem R Abu-Rustum; Mary E Charlson; Dennis S Chi Journal: Gynecol Oncol Date: 2015-05-31 Impact factor: 5.482
Authors: Jian-Feng Lu; Erik Rasmussen; Beth Y Karlan; Ignace B Vergote; Lynn Navale; Mita Kuchimanchi; Rebeca Melara; Daniel E Stepan; David M Weinreich; Yu-Nien Sun Journal: Cancer Chemother Pharmacol Date: 2012-01-01 Impact factor: 3.333
Authors: Stephanie Nougaret; Yulia Lakhman; Mithat Gönen; Debra A Goldman; Maura Miccò; Melvin D'Anastasi; Sarah A Johnson; Krishna Juluru; Angela G Arnold; Ramon E Sosa; Robert A Soslow; Hebert Alberto Vargas; Hedvig Hricak; Noah D Kauff; Evis Sala Journal: Radiology Date: 2017-06-16 Impact factor: 11.105
Authors: N B Rettenmaier; C R Rettenmaier; T Wojciechowski; L N Abaid; J V Brown; J P Micha; B H Goldstein Journal: Br J Cancer Date: 2010-11-02 Impact factor: 7.640