scholarly journals Rising serum CA-125 levels within the normal range is strongly associated recurrence risk and survival of ovarian cancer

2019 ◽  
Author(s):  
Szymon Piatek ◽  
Grzegorz Panek ◽  
Zbigniew Lewandowski ◽  
Mariusz Bidzinski ◽  
Dominika Piatek ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Survival Rate ◽  
Complete Response ◽  
Ca 125 ◽  
Reference Level ◽  
Primary Therapy ◽  
Line Treatment ◽  
Normal Range ◽  
First Line ◽  
First Line Treatment

Abstract Background: In clinical practice alterations in CA125 concentration within normal range in patients with ovarian cancer after first-line treatment are common. Even minor increase in CA125 concentration is associated with patients’ anxiety and difficult interpretation and counselling for clinicians. The aim of this study was to evaluate the significance of CA125 fluctuations within reference level in patients who suffered from ovarian cancer with complete response after first-line treatment.Results: 168 patients with epithelial ovarian cancer, who achieved complete remission after first line treatment were enrolled in the study. CA125 concentration assessment was carried out during follow up visits. The recurrence of the disease was diagnosed on the first appearance of symptoms: clinical, radiological or histopathological/cytological. PFS and 5-year survival rate was calculated with Kaplan-Meier plots. Statistical analysis was performed with SAS / STAT® 9.4 / 14.4, SAS Institute Inc., Cary, NC, USA, 2017. Median concentration of CA125 after first-line therapy was 10 U/ml. Increasing CA125 concentration by > 5U/ml, 3 and 6 months after the treatment was associated with higher risk of relapse (HR=7.6, p<0.0001 and HR=5.29, p<0.0001 respectively). 5-year survival rate was significantly lower in patients with increased CA125 by 5 U/ml, 3 and 6 months after therapy (56.79% vs 0% and 50.62% vs 15.55%).Conclusions: Increased concentration of CA125 by > 5 U/ml within normal range, 3 and 6 months after treatment was unfavorable prognostic factor in ovarian cancer patients with complete response to primary therapy.

Predictive value of systematic inflammatory response biomarkers (NLR, LMR, PLR) in patients with ovarian cancer.

2017 ◽  
Vol 53 (3) ◽  
pp. 139-146
Author(s):  
Urszula Rychlik ◽  
Ewa Wójcik ◽  
Jadwiga Tarapacz ◽  
Katarzyna Brandys ◽  
Zofia Stasik ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Complete Response ◽  
Response To Treatment ◽  
Line Treatment ◽  
First Line ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio ◽  
Progression Of Disease ◽  
First Line Treatment

Introduction: The aim of the study was to assess the prognostic value of indicators calculated on the basis of initial hematology test results of neutrophil, lymphocyte, monocyte and platelet counts (NLR – neutrophil-to-lymphocyte ratio, LMR – lymphocyte-to-monocyte ratio, PLR – platelet-to-lymphocyte ratio) in patients with ovarian cancer and their compliance with the overall response to treatment. Materials and methods: Hematological tests were performed before first course of first-line chemotherapy in 145 patients with ovarian cancer. Response to treatment was assessed according to the RECIST1.1 criteria in all patients. Results: After the completion of first-line treatment, 70 (48.3%) patients had a complete response (CR) to the therapy. In this group, progression of disease occurred in 22 (31.4%) patients during 12 months of follow-up. In the CR group with progression, 17 (77.2%) presented high NLR and PLR levels. Among 48 (68.6%) patients with CR without progression after 12 months of follow-up, high levels of NLR and PLR were observed in 21 (43.8%) and 17 (35.4%) of them, respectively. Low LMRs were observed in 16 (72.7%) patients with progression and 16 (33.3%) without progression. Conclusion: High levels of NLR and PLR and low levels of LMR before treatment seems to predict 12-month disease progression in patients with complete response to first-line treatment.

Phase II study of carboplatin followed by sequential gemcitabine and paclitaxel as first-line treatment for advanced ovarian cancer

2007 ◽  
Vol 17 (2) ◽  
pp. 350-358 ◽  
Author(s):  
M. Friedlander ◽  
M. Buck ◽  
D. Wyld ◽  
M. Findlay ◽  
B. Fitzharris ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Phase Ii ◽  
Phase Ii Study ◽  
Gynecologic Cancer ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Line Treatment ◽  
First Line ◽  
Sequential Approach ◽  
First Line Treatment

The aim of this exploratory phase II study was to evaluate sequential chemotherapy with carboplatin followed by gemcitabine–paclitaxel combination in chemonaive patients with advanced ovarian cancer. The primary objective was to evaluate time to progressive disease (TTPD); secondary objectives included the evaluation of 1- and 3-year survival, response rates, and toxicity. Following initial debulking surgery or biopsy, patients with FIGO stage IIC–IV disease received four cycles of carboplatin area under the curve (AUC) 6 (day 1) every 21 days, followed by four cycles of gemcitabine 1000 mg/m2 (days 1 and 8) and paclitaxel 175 mg/m2 (day 8) every 21 days. A total of 47 patients enrolled, 44 (93.6%) completed the initial four cycles, and 39 patients (82.9%) completed the planned eight cycles. The median and maximum lengths of follow-up were 31.2 and 43.7 months, respectively. Median TTPD was 13.8 months (95% CI, 11.6–21.0 months), and median survival time was 31.2 months (95% CI, 25.2–39.6 months). Survival at 1 and 3 years was 95.7% and 44.2%, respectively. Of the 43 evaluable patients, most (95.3%) of them achieved a CA-125 marker response based on Gynecologic Cancer Intergroup (GCIG) definition. The partial response rate in the seven patients with measurable disease was 46.4%. Myelosuppression was the major toxicity, with grade 3 and 4 neutropenia observed in 76.6% patients and thrombocytopenia in 12.8% patients. The sequential approach of carboplatin followed by gemcitabine–paclitaxel as first-line treatment for patients with ovarian cancer is feasible and well tolerated, and depending upon the findings from other major trials, it may merit further evaluation.

scholarly journals Comparison of dose-dense vs. 3-weekly paclitaxel and carboplatin in the first-line treatment of ovarian cancer in a propensity score-matched cohort

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rafaela Pirolli ◽  
Viviane Teixeira Loiola de Alencar ◽  
Felipe Leonardo Estati ◽  
Adriana Regina Gonçalves Ribeiro ◽  
Daniella Yumi Tsuji Honda ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Ovarian Carcinoma ◽  
Matched Cohort ◽  
Line Treatment ◽  
First Line ◽  
Western Population ◽  
Dose Dense ◽  
First Line Treatment

Abstract Background Benefit of carboplatin and dose-dense weekly paclitaxel (ddCT) in first line treatment of ovarian cancer patients has been different in Western and Asian studies. In the present study we compare progression-free survival (PFS) of ddCT to three-weekly carboplatin and paclitaxel (CT) in first-line treatment of ovarian carcinoma in a single institution in a Western population. Materials and methods We conducted a retrospective review of medical records from patients with ovarian carcinoma treated in a tertiary cancer center from 2007 to 2018. All patients treated with ddCT or CT in the first-line setting were included. Patients who received first-line bevacizumab were not included. PFS and overall survival (OS) were compared in a propensity score-matched cohort to address selection bias. Patients were matched according to age, ECOG performance status, CA 125, FIGO stage, residual disease, and histological subtype, in a 1:2 ratio. Results Five hundred eighty-eight patients were eligible for propensity score matching, the final cohort consisted of 69 patients treated with ddCT and 138 CT group. Baseline characteristics were well-balanced. After a median follow-up of 65.1 months, median PFS was 29.3 vs 20.0 months, favouring ddCT treatment (p = 0.035). In the multivariate cox regression ddCT showed a 18% lower risk of progression (HR 0.82, 95% CI 0.68–0.99, p = 0.04). Overall survival data is immature, but suggested better outcomes for ddCT (not reached versus 78.8 months; p = 0.07). Conclusion Our retrospective study has shown superior PFS of ddCT over CT regimen in first-line treatment of ovarian carcinoma in a Western population not treated with bevacizumab.

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