Ovarian cancer antigen CA125: a prospective clinical assessment of its role as a tumour marker

Abstract

Summary Serum CA 125, quantified by an immunoradiometric assay employing the monoclonal antibody OC125 was found to be elevated in 48/58 (83%) of patients with established ovarian cancer. All histological types of carcinoma were antigen positive and there was a positive correlation between the frequency and level of serum CA125 and body burden of tumour. Twenty patients undergoing chemotherapy had serial CA125 estimations following a prospective protocol. Variation in CA125 level reflected disease progression or regression in 21/23 instances. Three of 9 patients tested showed an acute elevation of CA125 in the first week following chemotherapy and this effect predicted a good response to treatment. The natural half-life of CA125 in serum was estimated at -4.8 days, sufficiently short to allow changes in tumour volume to be rapidly reflected by a change in circulating antigen level. Although none of 15 patients with non-Hodgkin lymphoma demonstrated antigen levels outside the normal range, 11/27 patients with non-ovarian adenocarcinoma showed elevated CA125 levels, a specificity of 58% for this latter group. The value of CA125 in the management of ovarian malignancy is discussed.

A new immunoassay using monoclonal antibodies HMFG1 and HMFG2 together with an existing marker CA125 for the serological detection and management of epithelial ovarian cancer

“…Correlation with clinical course of disease (Table IV; Figure la- This study confirms the previously demonstrated utility of CA 125 as a marker in ovarian cancer (Bast et al, 1983;Canney et al, 1984 Patients with high levels of PLAP had a poor prognosis in agreement with previous studies (Doellgast & Homesley, 1984). These differences may reflect cellular heterogeneity within a tumour either in terms of sensitivity to therapy or in terms of cell loss mechanisms.…”

“…Chemotherapy schedules and patient assessment were as previously reported (Canney et al, 1984 globule. The mouse used for the development of HMFG2 also received cultured milk epithelial cells (Arklie et al, 1981).…”

“…Although second-look laparotomy can provide further information about disease status the procedure, in itself, does not improve survival (Cohen et al, 1983). Recently a radioimmunoassay has been developed, incorporating monoclonal antibody CA 125, which is of value in monitoring the response to therapy in approximately 85% of patients with ovarian cancer (Bast et al, 1983;Canney et al, 1984).…”

Application of tumor markers in ovarian malignancies

“…The sensitivity of serum CA 125 for pretreatment ovarian carcinoma varied from 43%-97% depending on the stage of ovarian malignancy. The progressive increase of sensitivity was observed from stage I to stage IV (stage 1:43%, stage I1: 85%, stage II1: 93%, stage IV: 97%, overall sensitivity for all stages : 82%) thus reflecting that the sensitivity increases with advancing stage of malignancy (18)(19)(20)(21)(22). In addition, this marker is also reported to be elevated in malignancies of breast (17.6%), colorectal (15.1%), gastric (30.9%), esophagus (10.5%), liver (49%), biliary tract (45.8%), pancreas (52.6%), lung (29.5%), and endometrium (31.8%).…”

Tumour marker antigen CA125 in pancreatic cancer: A comparison with CA19-9 and CEA

“…An immunoradiometric assay has been developed to measure the concentrations of CA125 . High concentrations of CA125 have been found in more than 80 percent of sera from patients with ovarian cancer, and the test is especially promising in the follow-up of these patients Canney et al, 1984). Elevated serum CA125 levels have also been found in patients with various gastrointestinal cancers, especially in patients with pancreatic cancer (59%) Klug et al, 1984).…”