Prognostic value of serum CA 125 bi-exponential decrease during first line paclitaxel/platinum chemotherapy: A French multicentric study

Riedinger, Jean-Marc; Eche, N.; Basuyau, Jean-Pierre; Dalifard, I.; Hacène, K.; Mf, Pichon

doi:10.1016/j.ygyno.2008.01.035

Cited by 30 publications

(21 citation statements)

References 16 publications

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“…Furthermore, we have shown that patients whose CA125 half-life response to dose-dense therapy was faster compared with front-line therapy had an improved overall survival when compared with those with a slower response. This is consistent with previously published front-line studies, which suggest that a shorter half-life is associated with improved prognosis (Riedinger et al, 2008) (Mano et al, 2005) (Gadducci et al, 2004). No Although all the patients relapsed within a platinum-resistant interval, treatment was delayed in nine patients such that these patients did not receive a platinum regimen within 6 months.…”

Section: Discussionsupporting

confidence: 89%

Extended weekly dose-dense paclitaxel/carboplatin is feasible and active in heavily pre-treated platinum-resistant recurrent ovarian cancer

et al. 2009

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There is increasing evidence of the efficacy of dose-dense therapy in the management of platinum-resistant/refractory ovarian cancer. We report our experience of extended weekly carboplatin and paclitaxel in this population group. Twenty patients with platinumresistant/refractory ovarian cancer received carboplatin AUC 3 and paclitaxel 70 mg m À2 on day 1, 8, 15 q 4 weekly for six planned cycles. Toxicity was assessed using Common Toxicity Criteria. Response was evaluated using radiological and CA125 criteria. Median age was 61 years (range 40 -74 years). Median number of prior therapies is three (range 1 -8). Response rate was 60% by radiological criteria (RECIST) and 76% by CA125 assessment. Grade 3 toxicities consisted of neutropenia (29% of patients) and anaemia (5%). One patient experienced grade 4 neutropenia. No grade 3/4 thombocytopaenia was reported. Fatigue, nausea and peripheral neuropathy were the most frequent non-hematological side effects. Median progression-free survival was 7.9 months and overall survival was 13.3 months. The dynamics of response to dose-dense therapy were as rapid as with front-line therapy within the same patient. This dose-dense regimen can be extended to at least 18 weekly cycles over 6 months and is well tolerated with high response rates in heavily pre-treated, platinum-resistant ovarian cancer. It forms a highly active and tolerable cytotoxic scaffold to which molecular-targeted therapies can be added in platinum-resistant ovarian cancer.

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Section: Discussionsupporting

confidence: 89%

Extended weekly dose-dense paclitaxel/carboplatin is feasible and active in heavily pre-treated platinum-resistant recurrent ovarian cancer

et al. 2009

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“…Secondly, this study did not show a significant improvement of disease-free survival in propranolol group which is clinically important. Even though, there are several studies suggest that the early drop of CA 125 level is an independent prognostic factor for survival in patients with epithelial ovarian cancer [282930]. …”

Section: Discussionmentioning

confidence: 99%

Perioperative administration of propranolol to women undergoing ovarian cancer surgery: A pilot study

et al. 2017

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ObjectiveThis study was done to evaluate whether perioperative propranolol (ß-blocker) in ovarian cancer patients undergoing debulking surgery reduced perioperative tumor growth induced by surgical stress.MethodsThis was a prospective randomized single institution analysis. The primary objective was to compare the changes in CA 125 level (changes between preoperation day 2 and postoperative day 7). As a study arm, patients received a low dose of propranolol 40 mg/day (4×10 mg) starting two days before surgery and 40 mg twice daily for three days following surgery.ResultsTwenty-two patients were enrolled and 16 were evaluable for efficacy. The drug was well tolerated. The mean decrease of CA 125 during the seven perioperative days was 83.1±8.9% in the propranolol group and 72.4±14.7% in the placebo group. The difference was statistically significant (P=0.044). The change of C-reactive protein, cortisol, and anxiety score (State-Trait Anxiety Inventory-X1) were not different between the two groups.ConclusionThis preliminary result is the first to directly test the role of perioperative propranolol on tumor growth. Even with the small sample size and short term use of the drug, perioperative propranolol was effective in reducing tumor burden (as measured by CA 125) suggesting its potential benefits in decreasing perioperative tumor growth.

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“…This biomarker has been mainly used to monitor CT response [40] and during surveillance for patients in apparent remission [10]. This review has focused on the prognostic and predictive value of CA-125 during the primary treatment of EOC.…”

Section: Resultsmentioning

confidence: 99%

Prognostic and predictive value of CA-125 in the primary treatment of epithelial ovarian cancer: potentials and pitfalls

et al. 2012

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The serum cancer antigen 125 (CA-125) remains a reliable biomarker in the therapeutic management of epithelial ovarian cancer (EOC). Monitoring the efficacy of cytotoxic chemotherapy (CT) and the early detection of relapse during the follow up of patients in remission represent the two most common clinical situations where the CA-125 has been successfully applied. There are however other scenarios along the course of the disease where the CA-125 can potentially aid in the decision-making process. Preoperative levels of CA-125 can help in selecting a subset of patients where an optimal cytoreduction may not be easily achieved. Perioperative variations in the CA- 125 levels after primary surgery and, more importantly, the nadir value of the CA-125 after primary chemotherapy, are associated with patient outcome. This review focuses on the clinical relevance of dynamic changes in CA-125 levels during the primary treatment of EOC and its potential influence both in the patient management and in the design of clinical trials in the adjuvant setting.

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Prognostic value of serum CA 125 bi-exponential decrease during first line paclitaxel/platinum chemotherapy: A French multicentric study

Cited by 30 publications

References 16 publications

Extended weekly dose-dense paclitaxel/carboplatin is feasible and active in heavily pre-treated platinum-resistant recurrent ovarian cancer

Extended weekly dose-dense paclitaxel/carboplatin is feasible and active in heavily pre-treated platinum-resistant recurrent ovarian cancer

Perioperative administration of propranolol to women undergoing ovarian cancer surgery: A pilot study

Prognostic and predictive value of CA-125 in the primary treatment of epithelial ovarian cancer: potentials and pitfalls

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