Serum HE4 Profile During Primary Chemotherapy of Epithelial Ovarian Cancer

ObjectiveHuman epididymis protein 4 (HE4) is a promising novel serum biomarker for the detection of early-stage epithelial ovarian cancer (EOC) and for the differential diagnosis between benign and malignant ovarian tumors. The objective of the present study was to determine the value of HE4 for monitoring the response to primary therapy in patients with advanced disease.MethodsSerum HE4 and cancer antigen (CA) 125 levels of 10 patients with advanced EOC and one patient with adenocarcinoma of unknown origin were measured preoperatively and during first-line chemotherapy. Seven patients were treated with primary surgery and six cycles of chemotherapy. Response to treatment was evaluated 4 weeks after the completion of chemotherapy using computed tomography. Four patients received neoadjuvant chemotherapy (NACT) before surgery. To evaluate the early response to chemotherapy, changes in serum biomarker levels were compared with metabolic changes of tumors during NACT as detected by positron emission tomography/computed tomography.ResultsThe profile of HE4 during primary chemotherapy was in line with radiologic and clinical responses. In the neoadjuvant chemotherapy group, HE4 correlated better with the radiologic response than CA 125.ConclusionAssessment of serum HE4 may improve the reliability of response evaluation during chemotherapy for serous epithelial ovarian cancer.

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Prediction of survival in patients with epithelial ovarian cancer based on the timing and rate of normalization of CA125 levels during primary chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.5585 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 5585-5585

Author(s):

K. S. Matthews ◽

R. P. Rocconi ◽

M. Kemper ◽

K. E. Hoskins ◽

W. K. Huh ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Eligible Patient ◽

Primary Chemotherapy ◽

Rank Test ◽

Primary Therapy ◽

Linear Regression Models ◽

Platinum Sensitivity ◽

Platinum Based Chemotherapy ◽

Response To Chemotherapy

5585 Objective: CA125 is the tumor marker used to evaluate response to chemotherapy in patients with epithelial ovarian cancer (EOC). The aim of this study was to determine if the timing of normalization or percent decrease in CA125 levels during primary chemotherapy could predict survival. Methods: Patients treated at our institution for EOC with primary taxane/platinum-based chemotherapy for 6 cycles between 1996 and 2005 were eligible. Patient demographics, chemotherapy administration, CA125 levels, and survival outcomes were abstracted. Progression-free- survival (PFS), overall survival (OS), and platinum sensitivity (> 6 months from chemotherapy completion) were compared to CA125 levels during primary therapy. Baseline levels, change over time, and timing of CA125 normalization were calculated. Analyses were performed using Kaplan-Meier method and compared using the log-rank test, Chi-square test and Fischer’s exact test. Results: 269 patients with EOC were identified. When stratified by which cycle of chemotherapy achieved normalization, PFS ranged from 25 months at 1st cycle to 4 months at 6th cycle (p< 0.001). OS showed a similar benefit from 74 months at 1st cycle to 22 months at 6th cycle (p<0.001). Platinum sensitivity improved from 23% (normal CA125 after 6th cycle) to 72% (normal CA125 after 1st cycle) (p=0.003). Patients with normalization after the 3rd cycle or sooner compared to patients with normalization after the 4th cycle demonstrated improved PFS (19 vs. 6 months; p<0.001), OS (48 vs. 27 months; p=0.001) and platinum sensitivity (78 vs. 22%; p<0.001). Linear regression models of the slope of the decline of CA125 levels correlated with PFS (p=0.03); however, the models failed to predict an OS advantage. Conclusion: Earlier normalization of CA125 levels during primary chemotherapy for EOC predicts improvement in platinum sensitivity, PFS, and OS. This data provides prognostic information that may influence future decisions regarding chemotherapy. No significant financial relationships to disclose.

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RATIO OF SERUM CA125 TO RADIOLOGICAL PERITONEAL CARCINOMATOUS INDEX AS A NOVEL MARKER OF RESPONSE TO NEO ADJUVANT CHEMOTHERAPY AND PREDICTIVE MODEL OF SURGICAL OUTCOME IN ADVANCED EPITHELIAL OVARIAN CANCER- A SINGLE INSTITUITIONAL STUDY.

10.36106/ijar/5408387 ◽

2020 ◽

pp. 1-3

Author(s):

Prem Kumar Devdoss ◽

Prasanna Srinivasa Rao H ◽

N. Roobalakshmi

Keyword(s):

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Neoadjuvant Chemotherapy ◽

Epithelial Ovarian Cancer ◽

Ca 125 ◽

Newly Diagnosed ◽

Response To Chemotherapy ◽

Serum Ca125 ◽

Advanced Epithelial Ovarian Cancer ◽

Neo Adjuvant Chemotherapy

Objective: The objective of this retrospective study is to develop a novel marker- ratio of serum CA 125 to peritoneal carcinomatous index(PCI) - to predict the response in women receiving neoadjuvant chemotherapy for newly diagnosed advanced epithelial ovarian cancer at our centre. Methods: Medical records of women who were newly diagnosed with inoperable advanced ovarian cancer stages III and IV at our centre were selected. Only people with completely documented records in the years 2017 & 2018 were selected. Only patietns with serous histology were chosen. Pre chemotherapy serum CA125 value was noted. Radiological PCI was calculated by reviewing the CECT films & reports of the patients. Patients were compared with the ratio of CA125 to radiological PCI and clinical & pathological response to neo adjuvant chemotherapy. All patients received standard doses of three weekly Paclitaxel and Carboplatin based chemotherapy. Based on the ratio of CA125 to PCI patients were divided into 2 groups – ratio more than 100 and less than 100. Results: A total of 34 were patients were found to meet the eligible criteria. Response assessment was done after 3 to 4 cycles of neoadjuvant chemotherapy. The overall response rate to neoadjuvant chemotherapy in patients in group 1 ( CA125/PCI ratio > 100) was significantly higher as compared to patients in group 2 (CA125/PCI ratio <100). Conclusion: In summary, CA 125 to PCI ratio is novel method to predict response to chemotherapy in advanced epithelial ovarian cancers. This value is a helpful measurement that allows the clinicians to measure the degree of chemosensitivity prior to cytoreductive surgery. This measures the inherent tumor biology and to aids in surgical decision making regarding the role and extent of cytoreduction as well as alternate systemic/local therapies.

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A multicenter assessment of the ability of preoperative computed tomography scan and CA-125 to predict gross residual disease at primary debulking for advanced epithelial ovarian cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2017.02.020 ◽

2017 ◽

Vol 145 (1) ◽

pp. 27-31 ◽

Cited By ~ 32

Author(s):

Rudy S. Suidan ◽

Pedro T. Ramirez ◽

Debra M. Sarasohn ◽

Jerrold B. Teitcher ◽

Revathy B. Iyer ◽

...

Keyword(s):

Computed Tomography ◽

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Residual Disease ◽

Ca 125 ◽

Computed Tomography Scan ◽

Advanced Epithelial Ovarian Cancer ◽

Tomography Scan

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Is there a CA-125 level that predicts negative second look surgery (SLS) in patients with advanced epithelail ovarian cancer (EOC)?

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.15042 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 15042-15042

Author(s):

S. Sharma ◽

P. Singhal ◽

K. Odunsi ◽

S. Lele

Keyword(s):

Ovarian Cancer ◽

Disease Free Survival ◽

Disease Status ◽

Primary Treatment ◽

Ca 125 ◽

Primary Therapy ◽

Second Look ◽

Kaplan Meier ◽

Response To Chemotherapy ◽

Disease Free

15042 Background: The value of second look surgery (SLS) in advanced epithelial ovarian cancer (EOC) has been has been questioned because performing this procedure has not been associated with a clear survival advantage.However, SLS continues to be the most accurate means of documenting the response to chemotherapy, and therfore still used in investigational protocols. The primary purpose of this study was to assess the levels of CA 125 after treatment, that could predict absence of disease at SLS. Methods: Between 1998 and 2003, 98 stage III EOC patients who underwent optimal cytoreductive surgery, completed 6 cycles of platinum/paclitaxel chemotherapy, and were NED (no evidence of disease: normal CA 125, normal physical and radiological examination) were included in this study. SLS was performed at 6–8 weeks from completion of primary therapy. Patients with disease present at SLS were considered to have persistent disease and received second line chemotherapy. Patient demographics, surgical and chemotherapy treatments, and CA 125 levels prior to start and at completion of primary treatment were collected retrospectively. Survival was estimated by the Kaplan-Meier method. Results: Forty seven out of 98 (48%) of optimally debulked patients who were NED at completion of primary therapy underwent SLS. Twenty-five out of 47 patients (53%) had evidence of disease at SLS and 22 out of 47 patients (47%) were NED at SLS. The median disease free survival was 42 months (95% CI 16, 81) in patients with negative SLS compared with 17 months (95% CI 9, 45) in patients who did not undergo SLS (p = 0.03). Estimated 5-year survival in patients with negative SLS was 90% compared to 50% in patients who did not undergo SLS (p = 0.05). CA 125 levels of ≤ 10 after completion of primary therapy was predictive of negative SLS (p < 0.05). Conclusions: SLS evaluation of disease status appears to be a more accurate than standard clinical evaluation in patients who are NED at completion of their primary therapy. Negative SLS also appears to be a predictor of improved disease free and overall survival. Furthermore, CA 125 ≤ 10 is predictive of negative SLS in patients who are NED after completion of primary therapy. No significant financial relationships to disclose.

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Dynamic analysis of serum Ca-125 levels during neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer: a retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205412 ◽

2020 ◽

Vol 10 (1) ◽

pp. 88

Author(s):

Adarsh Dharmarajan ◽

A. Remya ◽

Aswathi Krishnan

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Proportional Hazards ◽

Disease Free Survival ◽

Ca 125 ◽

Free Survival ◽

Proportional Hazards Regression ◽

Response To Chemotherapy ◽

Neo Adjuvant Chemotherapy ◽

Disease Free

Background: Assessment of CA-125 kinetics was commonly used as a tool for tumor response to chemotherapy in ovarian cancer patients. The study aimed to determine any logarithmic/linear relationship between pre-chemotherapy and pre-operative CA-125 levels in ovarian cancer.Methods: Total 52 patients who underwent neoadjuvant chemotherapy (NACT) followed by interval cytoreductive surgery were included. CA-125 levels before starting chemotherapy, during chemotherapy and the preoperative value, with the date of measurement recorded. Cox’s proportional hazards regression was used to evaluate univariate and independent multivariable association with the effect of clinical, pathological and CA-125 kinetic parameters on outcome endpoints. Results: The study couldn’t establish any relationship in logarithmic fall of CA-125 values among ovarian cancers as a result of neo-adjuvant chemotherapy. The disease-free survival among the patients was 12.2 months.Conclusions: There is an inverse relationship between serum CA-125 levels and survival in ovarian cancer. NACT resulted in adequate fall of CA-125 levels in most of the patients, but the rate of fall was not predictive of prognosis.

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