OBJECTIVE: The relationship between survival and early changes in the serum level of the CA-125 antigen in patients with advanced ovarian cancer remains poorly defined. METHODS: To explore this issue, the serum CA-125 values from 101 patients with advanced ovarian cancer who participated in a Southwest Oncology Group trial (SWOG 8412), which compared the systemic delivery of cisplatin/cyclophosphamide vs. carboplatin/cyclophosphamide (both delivered every 28 days for 6 cycles) in suboptimal residual stage III and IV ovarian cancer, were evaluated. All patients in this analysis had CA-125 values available for at least 8 weeks following initiation of chemotherapy. Cox proportional hazards regression was used in multivariate analysis to determine the prognostic significance of the CA-125 concentration. RESULTS: While pretreatment CA-125 values did not correlate with survival, the concentration of this tumor marker 8 weeks after initiation of therapy was a powerful independent prognostic factor. The median survivals for patients (n = 51) with a CA-125 < 35 U/ml, vs. patients (n = 50) with a CA-125 > 35 U/ml, at this time point, were 26 months and 15 months, respectively (P = 0.0001). Further, women with serum CA-125 values <50% of their pretreatment concentration at 8 weeks experienced a median survival of 21 months, compared to only 10 months for individuals with tumor marker levels >50% of their baseline value (P = 0.0003). CONCLUSION: Reduction in the serum CA-125 concentration over the initial two cycles of platinum-based chemotherapy is a powerful independent predictor of survival for patients with suboptimal stage III or IV ovarian cancer. Patients without significant declines in CA-125 after two cycles of platinum-based chemotherapy have a particularly poor prognosis.
OBJECTIVE: The relationship between survival and early changes in the serum level of the CA-125 antigen in patients with advanced ovarian cancer remains poorly defined. METHODS: To explore this issue, the serum CA-125 values from 101 patients with advanced ovarian cancer who participated in a Southwest Oncology Group trial (SWOG 8412), which compared the systemic delivery of cisplatin/cyclophosphamide vs. carboplatin/cyclophosphamide (both delivered every 28 days for 6 cycles) in suboptimal residual stage III and IV ovarian cancer, were evaluated. All patients in this analysis had CA-125 values available for at least 8 weeks following initiation of chemotherapy. Cox proportional hazards regression was used in multivariate analysis to determine the prognostic significance of the CA-125 concentration. RESULTS: While pretreatment CA-125 values did not correlate with survival, the concentration of this tumor marker 8 weeks after initiation of therapy was a powerful independent prognostic factor. The median survivals for patients (n = 51) with a CA-125 < 35 U/ml, vs. patients (n = 50) with a CA-125 > 35 U/ml, at this time point, were 26 months and 15 months, respectively (P = 0.0001). Further, women with serum CA-125 values <50% of their pretreatment concentration at 8 weeks experienced a median survival of 21 months, compared to only 10 months for individuals with tumor marker levels >50% of their baseline value (P = 0.0003). CONCLUSION: Reduction in the serum CA-125 concentration over the initial two cycles of platinum-based chemotherapy is a powerful independent predictor of survival for patients with suboptimal stage III or IV ovarian cancer. Patients without significant declines in CA-125 after two cycles of platinum-based chemotherapy have a particularly poor prognosis.
Authors: Oliver Zivanovic; Camelia S Sima; Alexia Iasonos; Katherine M Bell-McGuinn; Paul J Sabbatini; Mario M Leitao; Douglas A Levine; Ginger J Gardner; Richard R Barakat; Dennis S Chi Journal: Gynecol Oncol Date: 2009-08-07 Impact factor: 5.482
Authors: Thomas C Krivak; Chunqiao Tian; G Scott Rose; Deborah K Armstrong; G Larry Maxwell Journal: Gynecol Oncol Date: 2009-07-12 Impact factor: 5.482
Authors: Elizabeth Won; Arti Hurria; Tao Feng; Supriya Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; William P Tew Journal: Int J Gynecol Cancer Date: 2013-07 Impact factor: 3.437
Authors: Kristin K Zorn; Chunqiao Tian; William P McGuire; William J Hoskins; Maurie Markman; Franco M Muggia; Peter G Rose; Robert F Ozols; David Spriggs; Deborah K Armstrong Journal: Cancer Date: 2009-03-01 Impact factor: 6.860
Authors: Yong Soon Kwon; Joo-Hyun Nam; Dae-Yeon Kim; Dae-Shik Suh; Jong-Hyeok Kim; Yong Man Kim; Young Tak Kim Journal: J Korean Med Sci Date: 2009-07-30 Impact factor: 2.153