Significance of early changes in the serum CA-125 antigen level on overall survival in advanced ovarian cancer

Maurie Markman, Massimo Federico, P. Y. Liu, Edward Hannigan, David S Alberts

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Objective.: The relationship between survival and early changes in the serum level of the CA-125 antigen in patients with advanced ovarian cancer remains poorly defined. Methods.: To explore this issue, the serum CA-125 values from 101 patients with advanced ovarian cancer who participated in a Southwest Oncology Group trial (SWOG 8412), which compared the systemic delivery of cisplatin/cyclophosphamide vs. carboplatin/cyclophosphamide (both delivered every 28 days for 6 cycles) in suboptimal residual stage III and IV ovarian cancer, were evaluated. All patients in this analysis had CA-125 values available for at least 8 weeks following initiation of chemotherapy. Cox proportional hazards regression was used in multivariate analysis to determine the prognostic significance of the CA-125 concentration. Results.: While pretreatment CA-125 values did not correlate with survival, the concentration of this tumor marker 8 weeks after initiation of therapy was a powerful independent prognostic factor. The median survivals for patients (n = 51) with a CA-125 < 35 U/ml, vs. patients (n = 50) with a CA-125 > 35 U/ml, at this time point, were 26 months and 15 months, respectively (P = 0.0001). Further, women with serum CA-125 values <50% of their pretreatment concentration at 8 weeks experienced a median survival of 21 months, compared to only 10 months for individuals with tumor marker levels >50% of their baseline value (P = 0.0003). Conclusion.: Reduction in the serum CA-125 concentration over the initial two cycles of platinum-based chemotherapy is a powerful independent predictor of survival for patients with suboptimal stage III or IV ovarian cancer. Patients without significant declines in CA-125 after two cycles of platinum-based chemotherapy have a particularly poor prognosis.

Original languageEnglish (US)
Pages (from-to)195-198
Number of pages4
JournalGynecologic Oncology
Volume103
Issue number1
DOIs
StatePublished - Oct 2006

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CA-125 Antigen
Ovarian Neoplasms
Survival
Serum
Platinum
Drug Therapy
Cyclophosphamide
Carboplatin
Tumor Biomarkers
Cisplatin
Multivariate Analysis

Keywords

  • Ovarian cancer
  • Platinum chemotherapy
  • Serum CA-125 antigen

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Significance of early changes in the serum CA-125 antigen level on overall survival in advanced ovarian cancer. / Markman, Maurie; Federico, Massimo; Liu, P. Y.; Hannigan, Edward; Alberts, David S.

In: Gynecologic Oncology, Vol. 103, No. 1, 10.2006, p. 195-198.

Research output: Contribution to journalArticle

Markman, Maurie ; Federico, Massimo ; Liu, P. Y. ; Hannigan, Edward ; Alberts, David S. / Significance of early changes in the serum CA-125 antigen level on overall survival in advanced ovarian cancer. In: Gynecologic Oncology. 2006 ; Vol. 103, No. 1. pp. 195-198.
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abstract = "Objective.: The relationship between survival and early changes in the serum level of the CA-125 antigen in patients with advanced ovarian cancer remains poorly defined. Methods.: To explore this issue, the serum CA-125 values from 101 patients with advanced ovarian cancer who participated in a Southwest Oncology Group trial (SWOG 8412), which compared the systemic delivery of cisplatin/cyclophosphamide vs. carboplatin/cyclophosphamide (both delivered every 28 days for 6 cycles) in suboptimal residual stage III and IV ovarian cancer, were evaluated. All patients in this analysis had CA-125 values available for at least 8 weeks following initiation of chemotherapy. Cox proportional hazards regression was used in multivariate analysis to determine the prognostic significance of the CA-125 concentration. Results.: While pretreatment CA-125 values did not correlate with survival, the concentration of this tumor marker 8 weeks after initiation of therapy was a powerful independent prognostic factor. The median survivals for patients (n = 51) with a CA-125 < 35 U/ml, vs. patients (n = 50) with a CA-125 > 35 U/ml, at this time point, were 26 months and 15 months, respectively (P = 0.0001). Further, women with serum CA-125 values <50{\%} of their pretreatment concentration at 8 weeks experienced a median survival of 21 months, compared to only 10 months for individuals with tumor marker levels >50{\%} of their baseline value (P = 0.0003). Conclusion.: Reduction in the serum CA-125 concentration over the initial two cycles of platinum-based chemotherapy is a powerful independent predictor of survival for patients with suboptimal stage III or IV ovarian cancer. Patients without significant declines in CA-125 after two cycles of platinum-based chemotherapy have a particularly poor prognosis.",
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AB - Objective.: The relationship between survival and early changes in the serum level of the CA-125 antigen in patients with advanced ovarian cancer remains poorly defined. Methods.: To explore this issue, the serum CA-125 values from 101 patients with advanced ovarian cancer who participated in a Southwest Oncology Group trial (SWOG 8412), which compared the systemic delivery of cisplatin/cyclophosphamide vs. carboplatin/cyclophosphamide (both delivered every 28 days for 6 cycles) in suboptimal residual stage III and IV ovarian cancer, were evaluated. All patients in this analysis had CA-125 values available for at least 8 weeks following initiation of chemotherapy. Cox proportional hazards regression was used in multivariate analysis to determine the prognostic significance of the CA-125 concentration. Results.: While pretreatment CA-125 values did not correlate with survival, the concentration of this tumor marker 8 weeks after initiation of therapy was a powerful independent prognostic factor. The median survivals for patients (n = 51) with a CA-125 < 35 U/ml, vs. patients (n = 50) with a CA-125 > 35 U/ml, at this time point, were 26 months and 15 months, respectively (P = 0.0001). Further, women with serum CA-125 values <50% of their pretreatment concentration at 8 weeks experienced a median survival of 21 months, compared to only 10 months for individuals with tumor marker levels >50% of their baseline value (P = 0.0003). Conclusion.: Reduction in the serum CA-125 concentration over the initial two cycles of platinum-based chemotherapy is a powerful independent predictor of survival for patients with suboptimal stage III or IV ovarian cancer. Patients without significant declines in CA-125 after two cycles of platinum-based chemotherapy have a particularly poor prognosis.

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