Early detection of recurrence or progression disease in patients with ovarian cancer after primary debulking surgery. Correlation between CT findings and CA 125 levels

Giuliani, Michela; Gui, Benedetta; Valentini, Anna Lia; Giovanni, Silvia Eleonora Di; Miccò, Maura; Rodolfino, Elena; Falcione, Matteo; Waure, Chiara de; Palluzzi, Eleonora; Salutari, Vanda; Scambia, Giovanni; Manfredi, Riccardo

doi:10.23736/s0026-4784.17.04062-x

Cited by 5 publications

(3 citation statements)

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“…In recurrent ovarian cancer, early detection of low volume disease is possible with CA-125 surveillance. 36 We are studying the potential synergy of carboplatin with pembrolizumab with a modified regimen in patients with ovarian cancer with low volume disease, with biochemical recurrences, to optimize the tumor burden side of this ratio (NCT# 04387227). Overall, these findings suggest that strategies such as using platinum as an immune sensitizer in select patients may improve efficacy of anti-PD1/ PD-L1-based therapies, even in cancers considered less immunogenic.…”

Section: Discussionmentioning

confidence: 99%

Pembrolizumab with low-dose carboplatin for recurrent platinum-resistant ovarian, fallopian tube, and primary peritoneal cancer: survival and immune correlates

Liao

Gwin

Urban

et al. 2021

J Immunother Cancer

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BackgroundAnti-programmed death 1 (PD1)/programmed cell death ligand 1 (PD-L1) therapies have shown modest activity as monotherapy in recurrent ovarian cancer. Platinum chemotherapies induce T-cell proliferation and enhance tumor recognition. We assessed activity and safety of pembrolizumab with carboplatin in recurrent platinum-resistant ovarian cancer.Patients and methodsThis phase I/II, single-arm clinical trial studied concurrent carboplatin and pembrolizumab in recurrent platinum-resistant ovarian, fallopian tube, and primary peritoneal cancer. Primary platinum refractory patients were excluded. Patients were treated after progression on subsequent non-platinum systemic therapy after becoming platinum resistant or refractory. Pembrolizumab 200 mg was given on day 1 and carboplatin area under the curve 2 on days 8 and 15 of a 3-week cycle until progression. Imaging was assessed by blinded independent review. PD-L1 expression was assessed by immunohistochemistry. Flow cytometry on peripheral blood mononuclear cells was performed for CD3, CD4, CD8, PD1, CTLA4 and Ki67.ResultsThe most common treatment-related adverse events were lymphopenia (18%) and anemia (9%) with most being grade 1 or 2 (93%). Of 29 patients treated, 23 patients were evaluable for best objective response: 10.3% (95% CI 2.2 to 27.4) had partial response (PR), 51.7% (95% CI 32.5 to 70.6) had stable disease (SD). 56.5% of patients had decreases in target lesions from baseline. All PD-L1-positive patients achieved PR (3/7, 42.8%) or SD (4/7, 57.2%). Median progression-free survival was 4.63 months (95% CI 4.3 to 4.96). Median OS was 11.3 months (95% CI 6.094 to 16.506). Peripheral CD8+PD1+Ki67+ T cells expanded after 3 (p=0.0015) and 5 (p=0.0023) cycles. CTLA4+PD1+CD8+ T cells decreased through the course of treatment up to the 12th cycle (p=0.004). When stratified by ratio of peripheral CD8+PD1+Ki67+ T cells to tumor burden at baseline, patients with a ratio ≥0.0375 who had a significantly longer median OS of 18.37 months compared with those with a ratio <0.0375 who had a median OS of 8.72 months (p=0.0099). No survival advantage was seen with stratification by tumor burden alone (p=0.24) or by CD8+PD1+Ki67+ T cells alone (p=0.53).ConclusionsPembrolizumab with carboplatin was well-tolerated and active in recurrent platinum-resistant ovarian cancer. A ratio of peripheral T-cell exhaustion to radiographic tumor burden may identify patients more likely to benefit from this chemoimmunotherapy.Trial registration numberNCT03029598.

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Section: Discussionmentioning

confidence: 99%

Pembrolizumab with low-dose carboplatin for recurrent platinum-resistant ovarian, fallopian tube, and primary peritoneal cancer: survival and immune correlates

Liao

Gwin

Urban

et al. 2021

J Immunother Cancer

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“…In addition to exploring the relationship between CA125 and Biochemical Recurrence, CA125 levels could also determine when to conduct imaging evalu-ation, improve the possibility of optimal secondary tumor reduction, and predict survival time. Giuliani suggested that a CT examination should be performed in time to evaluate recurrent lesions when the level of CA125 was higher than 10.5% [42]. Qin Xue found that when CA125 increased 3 times in a row within the normal range (within 35 kU/L) after initial treatment, an early recurrence should be confirmed by timely imaging examination [41].…”

Section: Ca125 With Recurrent Ovarian Cancermentioning

confidence: 99%

New Progress of CA125 Surveillance in Diagnosis and Treatment of Ovarian Cancer

Du,

Tang

2024

JBM

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The fatality rate of ovarian cancer (OC) is the highest, and the 5-year survival rate is only 50.8%. For more than 40 years, CA125 has been the most concerned and widely used biomarker of OC in clinical practice. In recent years, many researchers have proposed a reliable strategy of multiple markers combined with CA125 to screen OC to make up for the lack of accuracy of CA125, redefine the biochemical recurrence threshold of CA125, and use mathematical model scores to provide help for the feasibility of treatment and survival prognosis. To fully understand the role of CA125 in OC screening, initial treatment, and recurrence prediction, and summarize the limitations of CA125, this review has summarized the new progress of CA125 in the diagnosis and treatment of OC in recent years which can also provide a reference for clinicians.

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“…Changes less than 0.5% are predictive of the absence of progression. If changes range from 0.5% to 10.5%, and individualized clinical based approach is suggested (24). Increasing levels of CA125 precede the signs and symptoms of recurrence by 3-5 months in as many as 70% of cases (25).…”

Section: Ca125mentioning

confidence: 99%

Role of biomarkers for early detection of ovarian cancer recurrence

Giampaolino¹,

Foreste²,

Corte³

et al. 2020

Gland Surg

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Ovarian cancer is frequently diagnosed at an advanced stage and a fraction of these patients fail to respond to primary therapy and relapses in 70% of cases. On account of the high recurrence probability and the poor outcomes after recurrence, there is an urgent need to predict progression as early as possible and thus found the strategies to detect and prevent a recurrence. Considering that biomarkers have contributed to the management of ovarian cancer by distinguishing benign and malignant pelvic masses and monitoring response to treatment, in this review, we aim to discuss the latest evidence reported in the literature about the use of biomarkers to detect OC recurrence. In detail, we summarized all the evidence of the most quoted biomarkers like HE4, osteopontin, mesothelin (MSLN), Folate receptor α (FOLR1), paraneoplastic antigens, miRNA, cancer stem cells (CSCs) and a combination of them to evaluate their role as prognostic biomarkers for ovarian cancer recurrence.

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Early detection of recurrence or progression disease in patients with ovarian cancer after primary debulking surgery. Correlation between CT findings and CA 125 levels

Cited by 5 publications

References 0 publications

Pembrolizumab with low-dose carboplatin for recurrent platinum-resistant ovarian, fallopian tube, and primary peritoneal cancer: survival and immune correlates

Pembrolizumab with low-dose carboplatin for recurrent platinum-resistant ovarian, fallopian tube, and primary peritoneal cancer: survival and immune correlates

New Progress of CA125 Surveillance in Diagnosis and Treatment of Ovarian Cancer

Role of biomarkers for early detection of ovarian cancer recurrence

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