Prechemotherapy serum CA125 level as a predictor of survival outcome in epithelial carcinoma of the ovary

Davidson, N.; Khanna, Subhash; Kirwan, P.H.; Bircumshaw, Denise

doi:10.1016/s0936-6555(05)81038-6

Cited by 14 publications

(12 citation statements)

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“…Prechemotherapy CA125 level has been previously shown to be an independent prognostic factor for overall survival and is commonly used as a surrogate for tumor burden. 14,21 In our study, older women with elevated CA125 were more likely to experience grades 3 to 5 chemotherapy toxicity, especially nonhematologic toxicity, and require dose reductions. They were also more likely to require assistance with their activities of daily living and have lower physician-rated KPS.…”

Section: Discussionmentioning

confidence: 59%

CA125 Level Association With Chemotherapy Toxicity and Functional Status in Older Women With Ovarian Cancer

Won

Hurria

Feng

et al. 2013

International Journal of Gynecological Cancer

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Objective Older women with ovarian cancer have increased cancer-related mortality and chemotherapy toxicity. CA125 is a sensitive biomarker for tumor burden. The study evaluates the association between CA125, geriatric assessment (GA), and treatment toxicity. Methods This is a secondary subset analysis of patients age ≥65 with ovarian cancer accrued to a multicenter prospective study that developed a predictive toxicity score for older adults with cancer. Clinical and geriatric covariates included sociodemographics, GA (comorbidity, social support, functional, nutritional, psychological, cognitive status), treatment, and labs. Utilizing bivariate analyses, we determined the association of abnormal CA125 (≥35 U/mL) with baseline GA, grade 3–5 toxicity (CTCAE v.3), dose adjustments, and hospitalization. Logistic regression analysis was used to check for potential confounder for association between CA125 and chemotherapy toxicity. Results Fifty-one (10%) of 500 patients accrued to the primary study had a diagnosis of ovarian (92%), peritoneal (4%), or fallopian tube (4%) cancer. Median age was 72 (range, 65–86). Forty-six patients (90%) had stage III–IV disease. Twenty-three patients (45%) received first-line chemotherapy, and 34 (67%) received platinum-doublet therapy. Thirty-six (71%) had an abnormal CA125. Grade 3–5 toxicity occurred in 19 patients (37%). Abnormal CA125 was associated with assistance with instrumental activities of daily living (IADL) (p<0.05), lower performance status (p=0.05), grade 3–5 toxicity (p=0.03), non-heme toxicity (p=0.04), and dose reductions (p=0.01). No association between CA125 level and total toxicity score was observed. Conclusions Among older women with ovarian cancer, abnormal CA125 was associated with poor pre-treatment functional status and an increased probability of chemotherapy toxicity and dose reduction.

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Section: Discussionmentioning

confidence: 59%

CA125 Level Association With Chemotherapy Toxicity and Functional Status in Older Women With Ovarian Cancer

Won

Hurria

Feng

et al. 2013

International Journal of Gynecological Cancer

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“…More recently their value in predicting prognosis has been studied. In particular, serum concentrations of CA125 and placental alkaline phosphatase (PLAP) have been shown to have an inverse correlation with survival 2–7 .…”

Section: Introductionmentioning

confidence: 99%

Serum concentrations of cancer antigen 125, placental alkaline phosphatase, cancer‐associated serum antigen and free beta human chorionic gonadotrophin as prognostic markers for epithelial ovarian cancer

Ind

Iles

Shepherd

et al. 1997

BJOG

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Objective To investigate the prognostic significance of elevated levels of cancer antigen 125 (CA125), placental alkaline phosphatase (PLAP), free p human chorionic gonadotrophin (hCG) and cancerassociated serum antigen (CASA) in women with primary epithelial ovarian carcinoma.Design A two year follow up study of survival.Setting A tertiary care gynaecological oncology unit.Participants One hundred and eleven women with histologically confirmed epithelial ovarian cancer. Main outcome measures Survival over a two year period.Results Stage corrected log-rank x2 tests demonstrated a significant effect on survival for all four tumour markers (CAI25 P = 0.0142; PLAP P < 0.0001; CASA P = 0.0098; hCG P = 0.0002). This was confirmed when each variable was fitted together with disease stage in Cox proportional hazard models. When fitted as multiple variables in a Cox proportional hazard model, the addition of free phCG and CASA to disease stage, PLAP concentrations and CAI25 levels did not demonstrate M e r prognostic value.Conclusions Levels of all four markers correlate with survival in patients with epithelial ovarian cancer.The combination of PLAP and CA125 concentrations together with disease stage may be used to predict survival but the addition of hCG and CASA levels do not give additional prognostic information. INTRODUCTIONMeasurement of circulating tumour markers in cases of epithelial ovarian cancer has been advocated for monitoring disease progression'. More recently their value in predicting prognosis has been studied. In particular, serum concentrations of CA125 and placental alkaline phosphatase (PLAP) have been shown to have an inverse correlation with To date, over 40 monoclonal antibodies against ovarian tumour-associated antigens have been reporteds. It is therefore important to know if serum concentrations of other tumour markers may predict prognosis. Furthermore, it is as yet unclear if the use of multiple markers gives additional prognostic infomation. Cancer-associated serum antigen (CASA) has been reported to have a high sensitivity9. Products of human chorionic gonadotrophin (hCG) have a prognostic Correspondence: Mr T. Ind, Department of Obstetrics and Gynaecology, Watford Hospital, Vicarage Road, Watford WD 1 8HB, UK. association with many tumours of the female reproductive tract'0.''. In this study we examined the prognostic value of PLAP, CA125, free P-hCG and CASA in women presenting with primary ovarian cancer. METHODSThe study included 111 consecutive women with histologically confirmed epithelial ovarian cancer who had serum collected before initial surgery between 199'1 and 1994. Serum was stored at -20°C. Specimens were available for PLAP measurements in all cases and in 99, 99 and 73 cases for CA125, CASA and free P-hCG respectively. This was due to inadequate sample volumes for the latter three analytes.The characteristics of the 111 women are summarised in Table 1 PLAPSerum concentrations of PLAP were measured in duplicate by an in-house immunoradiometric assay, as previously de...

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“…Für das Ovarialkarzinom existiert mit dem tumorassoziierten Antigen CA 125 ein Marker, der sich aufgrund seiner ausreichend hohen Spezifität und Sensitivität vor allem in der Rezidiverkennung und in der Therapieerfolgskontrolle bewährt hat [1-3, 5, 6, 9, 10]. Dies betrifft vor allem die Frage des Screenings, der Differentialdiagnostik und der Prognose [11][12][13][14][15][16]. Dies betrifft vor allem die Frage des Screenings, der Differentialdiagnostik und der Prognose [11][12][13][14][15][16].…”

Section: Zusammenfassungunclassified

Sinnvoller Einsatz der Tumormarker beim Ovarialkarzinom

Meier

1997

Gynäkologe

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Das tumorassoziierte Antigen CA 125 ist aufgrund seiner hohen Spezifität von 95 % und Sensitivität von 92 % für die Rezidiverkennung beim Ovarialkarzinom ein Standardmarker. Eine Ergänzung z. B. bei muzinösen Karzinomen, bei denen das CA 125 in ca 50 % negativ ausfällt, ist der Marker 72-4. Dagegen ist das CEA wegen seiner geringen Sensitivität beim Ovarialkarzinom heute obsolet.Tumormarker sind zur Beurteilung der Effektivität einer primären, aber auch einer Rezidivtherapie von Bedeutung. Unsinnig ist jedoch eine routinemäßige Markerbestimmung bei Tumoren mit primärer Progression ohne effektive Therapiemöglichkeiten. Bei Patientinnen mit initial günstiger Prognose dagegen können Markerkontrollen sinnvoll sein. Dadurch kann eventuell nach jahrelanger Tumorfreiheit frühzeitig ein Rezidiv erkannt und die neuerliche Therapie rechtzeitig begonnen werden.Zum generellen Screening bei asymptomatischen Patientinnen können Tumormarker keinen wesentlichen Beitrag leisten, auch nicht in Kombination mit der Vaginosonographie. Eine Studie ergab, daß bei entsprechenden Verdachtskriterien, bei denen eine Abklärung durch Laparotomie oder Laparoskopie notwendig war, der positive prädiktive Wert nur 1,5 % betrug. Lediglich bei Frauen der High-risk-Gruppe mit positiver Familienanamnese und/oder BRCA1-und BRCA2-Mutationen wären Tumormarkerkontrollen zu diskutieren.

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Prechemotherapy serum CA125 level as a predictor of survival outcome in epithelial carcinoma of the ovary

Cited by 14 publications

References 11 publications

CA125 Level Association With Chemotherapy Toxicity and Functional Status in Older Women With Ovarian Cancer

CA125 Level Association With Chemotherapy Toxicity and Functional Status in Older Women With Ovarian Cancer

Serum concentrations of cancer antigen 125, placental alkaline phosphatase, cancer‐associated serum antigen and free beta human chorionic gonadotrophin as prognostic markers for epithelial ovarian cancer

Sinnvoller Einsatz der Tumormarker beim Ovarialkarzinom

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