Use of CA-125 to Define Progression of Ovarian Cancer in Patients With Persistently Elevated Levels

Rustin, G. J. S.; Marples, Maria; Nelstrop, Ann E.; Mahmoudi, Mohamed; Meyer, Tim

doi:10.1200/jco.2001.19.20.4054

Cited by 179 publications

(127 citation statements)

References 6 publications

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“…The previously validated CA125 progression criteria (Rustin et al, 1996b(Rustin et al, , 2001Vergote et al, 2000) is defined as either a doubling of the CA 125 levels from the nadir value achieved during previous therapy or a doubling from the upper limit of normal. (Value defined at local laboratories.)…”

Section: Response Assessmentmentioning

confidence: 99%

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

et al. 2004

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We evaluated the sequential use of carboplatin, paclitaxel and topotecan in patients with advanced, previously untreated ovarian cancer. In total, 43 patients with advanced ovarian cancer and 41 cm residual disease were treated with sequential carboplatin (areaunder-the-curve (AUC) 5 days 1 and 22), paclitaxel (175 mg m À2 days 43 and 64) and topotecan (1.5 mg m À2 daily for 5 days from days 85, 106, 127 and 148). Median age of patients was 61 years. Median follow-up was 22.2 months (range 0.76 -50.6 months). In all, 34 (79%) patients received all eight cycles of treatment and nine (21%) withdrew. Of the 29 evaluable patients, 19 (66%) responded according to WHO and 30 of 36 (83%) patients according to CA125. The best overall response (CA125 and/or WHO) was 77% (33 of 43 patients). The response rates to sequential drugs based on 450% fall in CA125 were as follows: carboplatin, 77% (30 of 39 patients); paclitaxel, 65% (15 of 23 patients); topotecan, 38% (five of 13 patients). Two patients responded to paclitaxel and one to topotecan after failure to respond to preceding chemotherapy. Median survival and time to progression was 22.24 and 10.61 months, respectively. This study demonstrates that sequential chemotherapy with just two initial courses of carboplatin is a reasonable way to introduce new agents into first-line therapy for poor prognostic ovarian cancer patients.

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Section: Response Assessmentmentioning

confidence: 99%

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

et al. 2004

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“…All women (≥18 years old) had radiographically documented progression of recurrent, invasive epithelial ovarian, fallopian tube, or primary peritoneal cancer per Response Evaluation Criteria in Solid Tumors, version 1.0 (RECIST, v1.0) or CA-125 progression per Gynecologic Cancer Intergroup (GCIG) guidelines [20,21]. Other eligibility criteria included: patients had a Gynecologic Oncology Group (GOG) performance status ≤1, and a history of fewer than four anticancer therapies and at least one platinum-based regimen.…”

Section: Patientsmentioning

confidence: 99%

A phase 1b study of trebananib in combination with pegylated liposomal doxorubicin or topotecan in women with recurrent platinum-resistant or partially platinum-sensitive ovarian cancer

Vergote

Schilder

Pippitt

et al. 2014

Gynecologic Oncology

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Objective. To examine the tolerability and antitumor activity of trebananib plus pegylated liposomal doxorubicin (PLD) or topotecan in recurrent platinum-resistant or partially platinum-sensitive ovarian cancer.Methods. In this open-label phase 1b study, patients received trebananib 10 mg/kg or 15 mg/kg IV QW plus PLD 50 mg/m 2 (cohorts A1 and A3, respectively) or topotecan 4 mg/m 2 (cohorts B1 and B3, respectively). Endpoints were dose-limiting toxicity (DLT; primary); treatment-emergent adverse events (AEs), overall response rate, anti-trebananib antibodies, and pharmacokinetics (secondary).Results. 103 patients were enrolled. One patient in A1 and B1 had DLTs. Across all cohorts, the most common AEs were nausea, fatigue, and peripheral edema. Across both trebananib plus PLD cohorts (A1/A3), grade 4 AEs were pulmonary embolism, disease progression, and anemia. Two patients had grade 5 intestinal perforation (n = 1) and sudden death (n = 1). Across both trebananib plus topotecan cohorts (B1/B3), grade 4 AEs were neutropenia, hypokalemia, decreased granulocyte count, chest pain, dyspnea, decreased neutrophil count, and pulmonary embolism. Two patients had grade 5 disease progression. One patient had grade 5 pleural effusion associated with progressive disease. Confirmed objective response rates were 36.0% (A1), 34.8% (A3), 16.7% (B1), and 0.0% (B3). Median progression-free survival duration (months) was 7.4 (A1), 7.1 (A3), 3.5 (B1), and 3.1 (B3), respectively. No drug-drug interactions were apparent.

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“…Rustin et al found that a doubling of CA125 levels (twice the upper limit of normal) had 86% sensitivity and 91% specificity for detecting disease progression [26].…”

Section: Monitoring and Diagnosing Ovarian Cancer Relapsementioning

confidence: 99%

Recommendations for biomarker testing in epithelial ovarian cancer: a National Consensus Statement by the Spanish Society of Pathology and the Spanish Society of Medical Oncology

Oaknin

Guarch²,

Barretina-Ginesta

et al. 2017

Clin Transl Oncol

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Because of advances in the understanding of histological and molecular characteristics in ovarian cancer, it is now possible to recognize the existence of five subtypes, which in turn has allowed a more refined therapeutic approach and better design of clinical trials. Each of these five subtypes has specific histological features and a particular biomarker expression, as well as mutations in different genes, some of which have prognostic and predictive value. CA125 and HE4 are examples of ovarian cancer biomarkers used in the diagnosis and follow-up of these malignancies. Currently, somatic or germinal mutations on BRCA1 and BRCA2 genes are the most important biomarkers in epithelial ovarian cancer having prognostic and predictive value. This article will review the histological and molecular characteristics of the five subtypes of ovarian cancer, describing the most important biomarkers and mutations that can guide in diagnosis, screening and tailored treatment strategy.

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Use of CA-125 to Define Progression of Ovarian Cancer in Patients With Persistently Elevated Levels

Cited by 179 publications

References 6 publications

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

A phase II study of sequential carboplatin, paclitaxel and topotecan in patients with previously untreated advanced ovarian cancer

A phase 1b study of trebananib in combination with pegylated liposomal doxorubicin or topotecan in women with recurrent platinum-resistant or partially platinum-sensitive ovarian cancer

Recommendations for biomarker testing in epithelial ovarian cancer: a National Consensus Statement by the Spanish Society of Pathology and the Spanish Society of Medical Oncology

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