Predictors of pretreatment CA125 at ovarian cancer diagnosis: a pooled analysis in the Ovarian Cancer Association Consortium

Babić, Ana; Cramer, Daniel W.; Kelemen, Linda E.; Köbel, Martin; Steed, Helen; Webb, Penelope M.; Johnatty, Sharon E.; deFazio, Anna; Lambrechts, Diether; Goodman, Marc T.; Heitz, Florian; Matsuo, Keitaro; Hosono, Satoyo; Karlan, Beth Y.; Jensen, Allan; Kjær, Susanne K.; Goode, Ellen L.; Pejović, Tanja; Moffitt, Melissa; Høgdall, Estrid; Høgdall, Claus; McNeish, Iain A.; Terry, Kathryn L.

doi:10.1007/s10552-016-0841-3

Cited by 20 publications

(16 citation statements)

References 42 publications

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“…Babic et al 5 reviewed pretreatment CA 125 in 13 studies participating in the Ovarian Cancer Association Consortium. A total of 5091 women with invasive epithelial ovarian cancer had CA 125 measurements.…”

Section: Discussionmentioning

confidence: 99%

“…Study populations have included healthy postmenopausal women, women with BRCA mutations, and women with ovarian cancer. [2][3][4][5] In each of these studies, lower values of CA 125 were demonstrated in African-American women or non-white women. As CA 125 is a major component of risk of ovarian malignancy algorithm (ROMA), we investigated a database from 2 prospective studies, for an assessment of ethnic bias on ROMA and the multivariate index assay (MIA).…”

Section: Introductionmentioning

confidence: 96%

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Multivariate Index Assay Is Superior to CA125 and HE4 Testing in Detection of Ovarian Malignancy in African-American Women

Dunton

Bullock²

2019

Biomark�Cancer

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Objective: To review and analyze the serum values of risk of ovarian malignancy algorithm (ROMA) and multivariate index assay (MIA) in subgroups of women who underwent surgery for adnexal masses to determine sensitivity, specificity, and positive and negative predictive values for the detection of malignancy in different ethnic populations. Methods: Serum samples from 2 prospective trials of 1029 women in which 274 women diagnosed with malignancy were analyzed for ROMA scores and MIA results. Biomarker data were obtained from the previous prospective studies that validated the MIA test. Of these, 250 women were Caucasian (C) and 24 were African-American (AA). Sensitivity, specificity, positive and negative predictive values, and confidence intervals for preoperative test results were calculated using DTComPair package of the R programming language. In premenopausal women, a ROMA value equal to or greater than 1.14 indicates a high risk of finding epithelial ovarian cancer. In premenopausal women, MIA values greater than 5.0 are associated with a greater risk of malignancy. In postmenopausal women, a ROMA value equal to or greater than 2.99 indicates a high risk of finding epithelial ovarian cancer. In postmenopausal women, MIA values greater than 4.4 are associated with a greater risk of malignancy. Results: Primary ovarian malignancy was diagnosed in 179 cases (167 C/12 AA) and metastatic disease to the ovary in an additional 27 cases (22 C/5 AA). Overall results are shown below. Conclusions: Our results demonstrate that ROMA in AA women with adnexal masses have lower sensitivity for the detection of malignancy than does MIA. Implementation of MIA in the evaluation of adnexal masses will increase the sensitivity of the detection of malignancy compared with ROMA, with the most marked results in AA women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Multivariate Index Assay Is Superior to CA125 and HE4 Testing in Detection of Ovarian Malignancy in African-American Women

Dunton

Bullock²

2019

Biomark�Cancer

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“…Previous studies demonstrated serous ovarian cancers have highest CA125 level followed by endometrioid and clear cell types (4,21,22); one study showed CA125 is not expressed in pure mucinous tumors of ovarian cancer (4). Other studies demonstrated that besides tumor characteristics CA125 levels are also influenced by several epidemiologic factors (age, parity oral contraceptives) and suggest that high BMI may influence CA125 levels independent of tumor characteristics (22). This should be mentioned in CA125 levels.…”

Section: Discussionmentioning

confidence: 99%

Prognostic relevance of high pretreatment CA125 levels in primary serous ovarian cancer

Bachmann

Brucker

Stäbler³

et al. 2020

Mol Clin Oncol

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The objective of the present study was to analyze the prognostic relevance of pretreatment serum CA125 ≥500 U/ml and its role as a non-invasive factor for estimating optimal cytoreduction (≤1 cm) in primary serous ovarian cancer. Clinicopathological parameters and CA125 levels prior to primary cytoreductive surgery were retrospectively evaluated in all 261 consecutive patients with primary epithelial ovarian cancer from a single centre. Inclusion criteria were existing preoperative CA125 level, serous ovarian cancer and performed full primary treatment (surgery/platinum-based chemotherapy). A total of 136 patients met the criteria. Among them, 74 patients had CA125 ≥500 U/ml. The other 62 patients that met the aforementioned criteria and had CA125 <500 U/ml were defined as controls. The present study tested cut-off CA125 values to detect subgroups affecting prognosis. The goal was to evaluate patients with optimal cytoreduction (R≤1 cm). Univariate analyses were performed with PASW to identify clinicopathological parameters associated with the pretreatment CA125 level. For survival analyses, a cut-off-value of CA125 ≥500 U/ml was used to identify the association between preoperative CA125 levels, resection status and prognosis. To test significant differences between examined groups, Student's t-test and the Mann-Whitney test were used. P<0.05 was considered to indicate a statistically significant difference. Significantly worse prognosis in terms of overall survival (P=0.023) and progression-free survival (P=0.011) was detected in the CA125 ≥500 U/ml group of optimally cytoreduced patients compared with in the CA125 <500 U/ml group. The complete cytoreduction rate was higher in CA125 <500 U/ml (33.9%) vs. CA125 ≥500 U/ml (21.6%). A CA125 level >1,404 U/ml had a higher rate of suboptimal cytoreduction (32.4%) compared with lower CA125 levels. A pretreatment CA125 level ≥500 U/ml had significantly worse prognostic impact after optimal cytoreduction compared with CA125 <500 U/ml. The higher the CA125 level the higher the suboptimal cytoreduction rate. Patients with CA125 ≥500 U/ml may be candidates for an initial laparoscopic approach to specify resectability and to determine how to proceed. Overall, CA125 levels appear to be helpful in predicting suboptimal cytoreductive surgery for patients with primary ovarian cancer, but should be interpreted together with clinical and radiologic findings. This may improve defining the optimal treatment strategy in these patients.

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“…Babic et al [4] reviewed 5091 women with invasive epithelial ovarian cancer who had CA125 measurements in 13 different studies participating in the ovarian Cancer Association Consortium. The median CA125 value in non-White women in this analysis was 35.2% lower than that of white women.…”

Section: Discussionmentioning

confidence: 99%

Ethnic Disparity in Clinical Performance Between Multivariate Index Assay and CA125 in Detection of Ovarian Malignancy

Dunton¹,

Bullock²

2019

Future Oncol.

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Aim: Based on evidence that African–American (AA) women have lower CA125 values than Caucasian (C) women, we investigated this to see if this disparity would have an impact on ovarian cancer detection using CA125 and multivariate index assay (MIA). Materials & methods: Serum from two prospective trials of 1029 (274 malignancies [250 C/24AA]) were analyzed for CA125 and MIA results. Clinical performance was calculated. Results: Sensitivity of MIA in Caucasian women was 93.2%, 74.4% for CA125 at the ACOG approved cut-off level of 200 U/ml cutoff, and 80.4% using the 2007, Dearking 67 U/ml cutoff. In AA American women, MIA sensitivity was 79.2%, 33.3% for CA125 at the ACOG approved cut-off levels and 62.5% at the 2007, Dearking 67 U/ml cutoff. Conclusion: Our results support that CA125 in AA women with adnexal masses has lower sensitivity than MIA no matter what the cutoff value is. Implementation of MIA in evaluation of adnexal masses should increase sensitivity of detection of malignancy compared with CA125, particularly in AA women.

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Predictors of pretreatment CA125 at ovarian cancer diagnosis: a pooled analysis in the Ovarian Cancer Association Consortium

Cited by 20 publications

References 42 publications

Multivariate Index Assay Is Superior to CA125 and HE4 Testing in Detection of Ovarian Malignancy in African-American Women

Multivariate Index Assay Is Superior to CA125 and HE4 Testing in Detection of Ovarian Malignancy in African-American Women

Prognostic relevance of high pretreatment CA125 levels in primary serous ovarian cancer

Ethnic Disparity in Clinical Performance Between Multivariate Index Assay and CA125 in Detection of Ovarian Malignancy

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