Tumor markers in the management of patients with ovarian cancer

Tuxen, M. K.; Sölétormos, György; Dombernowsky, P

doi:10.1016/0305-7372(95)90002-0

Cited by 126 publications

(92 citation statements)

References 115 publications

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“…The reason is not a lack of sensitivity of CA 125 for ovarian cancer, but the varying individual baseline values of CA 125 in healthy women. The lack of specifi city is caused by frequently increased levels of CA 125 in benign gynecological diseases such as endometriosis, fi bromas, uterine myomas, acute salpingitis and pelvic infl ammatory diseases (19) . In addition, several non-gynecological malignant diseases like lymphoma, lung cancer, breast cancer and gastrointestinal cancers may release CA 125 as well as benign diseases affecting the serous membranes of the peritoneum (liver cirrhosis, chronic active hepatitis, pancreatitis), pleura or pericardium (2,19) .…”

Section: Discussionmentioning

confidence: 99%

Human epididymis protein 4 (HE4) in benign and malignant diseases

Hertlein

Stieber

Kirschenhofer

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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Background: Human epididymis protein 4 (HE4) is described as a useful new biomarker in ovarian cancer. As HE4 is neither tumor nor organ specifi c, we intensively investigated the occurrence of this protein in female and male patients with various benign and malignant diseases in order to avoid misinterpretation and to identify potential additional clinical relevance. Methods:We retrospectively investigated HE4 (ARCHITECT ® , Abbott Diagnostics, US) in the sera of 205 healthy individuals, 654 patients with benign disorders and 720 patients with cancer before initial treatment. Results:The lowest concentrations of HE4 were observed in healthy men (median 26.2 pmol/L) followed by healthy women (median 40.4 pmol/L). In benign diseases, highest HE4 concentrations were seen in both women and men with renal failure (women, median 1041 pmol/L; men, median 1368 pmol/L). In women, the highest HE4 levels in malignant diseases were observed in ovarian cancer (median 242 pmol/l), whereas the highest HE4 concentrations in men occurred in lung cancer (median 89.2 pmol/L). The area under the curve (AUC) of HE4 in women was highest in ovarian cancer and borderline tumors as compared to benign gynecological disorders (88.9 % ), with a sensitivity of 67.4 % at 95 % specifi city. Also, signifi cantly elevated concentrations of HE4 with reference to the respective group of benign diseases were observed

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Section: Discussionmentioning

confidence: 99%

Human epididymis protein 4 (HE4) in benign and malignant diseases

Hertlein

Stieber

Kirschenhofer

et al. 2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…In many studies, serum CA 125 tumour marker level has been considered a reliable predictor of response to treatment (McGuire et al, 1989;Einzig et al 1992;Kohn et al, 1994;Tuxen et al, 1995). Of the twelve patients who entered the study, nine patients had pretreatment CA 125 levels of .100 kU l-' (normal range: up to 35 kU 1-').…”

Section: Paclitaxel Pharmacokineticsmentioning

confidence: 99%

A clinical and pharmacokinetic study of the combination of carboplatin and paclitaxel for epithelial ovarian cancer

Siddiqui

Boddy²,

Thomas³

et al. 1997

Br J Cancer

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Summary The aim of this phase study was to determine the maximum tolerated dose of a 3-h infusion of paclitaxel, combined with carboplatin at a fixed AUC of 7 mg ml-'min every 4 weeks for up to six cycles and to evaluate any possible pharmacokinetic interaction. Twelve chemonaive patients with ovarian cancer were treated with paclitaxel followed by a 30-min infusion of carboplatin. Paclitaxel dose was escalated from 150 mg m-2 to 225 mg m-2 in cohorts of three patients. Carboplatin dose was based on renal function. Pharmacokinetic studies were performed in nine patients (at least two at each dose level). A total of 66 courses were evaluable for assessment. Grade 3 or 4 neutropenia was seen in 70% of the courses, however hospitalization was not required. Grade 3 or 4 thrombocytopenia occurred in 24% of the courses. Alopecia, myalgia and peripheral neuropathy were common but rarely severe. The pharmacokinetics of paclitaxel was non-linear and did not appear to be influenced by co-administration of carboplatin. The AUC of carboplatin was 7.0±1.4 mg ml-' min, indicating that there was no pharmacokinetic interaction. The combination of carboplatin and paclitaxel may be administered as first-line treatment for advanced ovarian cancer. Although myelosuppression is the dose-limiting toxicity of the component drugs, the severity of thrombocytopenia was less than anticipated. The results of this study, with only a small number of patients, need to be confirmed in future investigations.

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“…An important characteristic of CA 125 is the ability to reflect changes in tumour mass during chemotherapy or in the follow-up period after completion of therapy. If patients have elevated serum CA 125 levels at diagnosis, serial serum CA 125 determinations during initial therapy accurately reflect the disease course in more than 74% of the matched events (clinical versus marker response, stability or progression) (Tuxen et al, 1995). However, there is no consensus concerning the interpretation of consecutive tumour marker concentrations and several different criteria have been proposed (Bast et al, 1983(Bast et al, , 1984Krebs et al, 1986;Fioretti et al, 1987;Panza et al, 1988;Gadducci et al, 1990Gadducci et al, , 1991Cruickshank et al, 1992;Fioretti et al, 1992;Rustin et al, 1992;Vergote et al, 1992;Rustin et al, 1993Rustin et al, , 1997, but none are able to eliminate the false positive marker signals as regards tumour progression.…”

mentioning

confidence: 99%

Serum tumour marker CA 125 in monitoring of ovarian cancer during first-line chemotherapy

Tuxen

Sölétormos²,

Dombernowsky

2001

Br J Cancer

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SummaryThe value of the serum tumour marker CA 125 to date has been in the monitoring of ovarian cancer patients for response to therapy and for recurrence of disease. However, despite the availability of serial data on CA 125, the problem of interpreting a change over time is still unsolved. The aim of this study was to assess the ability of CA 125 to monitor patients with ovarian cancer during postoperative chemotherapy. 255 patients with stage IC-IV ovarian cancer were allocated to the tumour marker monitoring study. The evaluation of CA 125 information was based on the analytical imprecision, the normal intra-individual biological variation, the sampling interval, and the cut-off value. Additionally, a new assessment criterion based upon an increment of 2.5 times the baseline CA 125 concentration confirmed by a third measurement was elaborated and the utility investigated. The efficiency of CA 125 for identifying progression and non-progression during first-line chemotherapy was 91.9%. The median lead time for true positive results was 41 days. Using the new elaborated criterion the efficiency of CA 125 for identifying progression and non-progression during first-line chemotherapy was 90.5%. The median lead time for true positive results was 35 days. CA 125 gave reliable prediction of progressive disease during postoperative chemotherapy. The results indicate a high applicability of the presented progression criteria during CA 125 monitoring of patients with changing activity of ovarian cancer.

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Tumor markers in the management of patients with ovarian cancer

Cited by 126 publications

References 115 publications

Human epididymis protein 4 (HE4) in benign and malignant diseases

Human epididymis protein 4 (HE4) in benign and malignant diseases

A clinical and pharmacokinetic study of the combination of carboplatin and paclitaxel for epithelial ovarian cancer

Serum tumour marker CA 125 in monitoring of ovarian cancer during first-line chemotherapy

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