The Prognostic Value of the CA-125 Elimination Rate (KELIM) as an Indicator of Response During Neo-Adjuvant Chemotherapy in Advanced-Stage Ovarian Cancer

5546 Background: A pre-operative predictive biomarker of CC0 interval debulking surgery (IDS) likelihood would be helpful. The modeled CA125 elimination rate constant KELIM predicts OS in 1st line setting (You et al. Clin Cancer Res 2019). The predictive/prognostic values of KELIM regarding CC scores at IDS, and survivals, during neo-adjuvant chemotherapy were assessed. Methods: The data of the CHIVA randomized phase II trial, comparing carboplatin-paclitaxel +/- nintedanib before IDS (NCT01583322), were used. A semi-mechanistic model was built to describe CA125 longitudinal kinetics during the first 100 treatment days. The relationships between KELIM and IDS CC scores, PFS & OS, were assessed with other major prognostic factors (grade, histology, GCIG CA125 response, FIGO stage, and arm) using multivariate logistic regression (logit), C-index & survival tests. Results: The longitudinal kinetics of 529 CA125 values, assessed every 3 weeks during neo-adj chemotherapy, were modeled in 133 patients (out of 188). KELIM (as a continuous covariate) was the only significant predictive factor of CC0 IDS likelihood using multivariate analyses (OR = 12.37, 95% CI [4.32-39.67]). CC0 IDS probability can be estimated with patient KELIM: ≥ 90 % if standardized KELIM ≥ 0.12. Non-parametric survival models confirmed the independent predictive values of KELIM categorized by terciles regarding PFS & OS (Table). The parametric model linking KELIM (as a continuous covariate) with OS allows to predict the patient survivals (months) based on their estimated KELIM (HR = 0.20, [0.10-0.39]). Conclusions: The prognostic & predictive values of the modeled CA125 KELIM are also confirmed regarding CC0 IDS likelihood, PFS and OS with neo-adjuvant chemotherapy. Patient KELIM is calculable online, based on observed CA125 values, on http://www.biomarker-kinetics.org/ . Clinical trial information: 2011-006288-23. [Table: see text]

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Prognostic value of serum CA-125 in patients with advanced epithelial ovarian cancer followed by complete remission after adjuvant chemotherapy

Obstetrics & Gynecology Science ◽

10.5468/ogs.2013.56.1.29 ◽

2013 ◽

Vol 56 (1) ◽

pp. 29 ◽

Cited By ~ 3

Author(s):

Jong Ho Moon ◽

Hyo Jin Lee ◽

Woo Dae Kang ◽

Chul Hong Kim ◽

Ho Sun Choi ◽

...

Keyword(s):

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Complete Remission ◽

Epithelial Ovarian Cancer ◽

Prognostic Value ◽

Ca 125 ◽

Advanced Epithelial Ovarian Cancer

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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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