Serum tumour marker CA 125 in monitoring of ovarian cancer during first-line chemotherapy

Tuxen, M. K.; Sölétormos, György; Dombernowsky, P

doi:10.1054/bjoc.2001.1787

Cited by 57 publications

(39 citation statements)

References 35 publications

(46 reference statements)

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“…Although CA125 concentrations at diagnosis are not associated with survival or extent of disease at diagnosis, 14 CA125 is reasonably reliable in predicting disease progression during initial chemotherapy. 15 Early normalization of CA125 during initial chemotherapy with a taxane and a platinum has been found to be positively associated with survival and negatively with persistence of disease at second-look laparotomy, 14,[16][17][18] as has CA125 nadir during treatment.…”

Section: Discussionmentioning

confidence: 99%

Lack of reliability of CA125 response criteria with anti‐VEGF molecularly targeted therapy

Azad

Annunziata

Steinberg

et al. 2008

Cancer

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BACKGROUNDCA125 is an accepted indicator of epithelial ovarian cancer (EOC) response and is used to monitor patients treated with cytotoxic chemotherapy. It is uncertain how CA125 is affected by molecularly targeted drugs. In this pilot study, the authors analyzed the utility of CA125 to predict disease behavior in patients who were receiving sorafenib, a Raf‐kinase/VEGFR2 inhibitor, and bevacizumab, an anti‐VEGF monoclonal antibody.METHODSFifteen of 42 patients had recurrent EOC. Patients received sorafenib 200 mg orally twice daily or D1‐5 of 7 and bevacizumab 5 mg/kg to 10 mg/kg intravenously every 2 weeks for 28‐day cycles. Computed tomography (CT) scans were performed every 2 cycles for restaging, and CA125 was measured monthly. CA125 concentrations were retrospectively analyzed as a function of clinical behavior.RESULTSFourteen of 15 patients had abnormal CA125 concentrations at study entry (median 1056 U/mL; range, 67 U/mL to 9813 U/mL). Seven (47%) patients had partial response by imaging criteria. Five of these 7 patients had partial response by CA125 criteria (71% sensitivity). Eight (53%) patients would have had partial responses if CA125 criteria were used; only 5 were confirmed by CT (63 % specificity). Imaging and CA125 criteria combined yielded a higher total response rate of 10 of 15 (67%). Three patients with objective partial response by imaging lasting >20, >22, and >24 cycles would have terminated treatment prematurely if CA125 had been used.CONCLUSIONSCA125 changes may not correspond to imaging response criteria for EOC patients who are receiving sorafenib and bevacizumab. Caution is recommended when using CA125 as a response criterion of molecularly targeted agents until prospective studies validate CA125 changes with objective imaging response results. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Lack of reliability of CA125 response criteria with anti‐VEGF molecularly targeted therapy

Azad

Annunziata

Steinberg

et al. 2008

Cancer

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“…Based on these findings, the investigators were able to mathematically determine the critical thresholds for response/progression in both those with normal (one-sided) or elevated (two-sided) CA125 baseline values. In a follow-up study validating the model, Tuxen et al determined that the efficiency of serial biomarker values for documenting progression among 255 stage IC-IV ovarian cancer patients undergoing platinum-based primary chemotherapy in the North Thames Ovary Trial was 92% [22]. The mean lead time to objective progression was 35 days.…”

Section: Discussionmentioning

confidence: 99%

Early Changes in CA125 After Treatment with Pegylated Liposomal Doxorubicin or Topotecan Do Not Always Reflect Best Response in Recurrent Ovarian Cancer Patients

Coleman

Gordon

Barter³

et al. 2007

The Oncologist

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Key Words. CA125 • Biomarkers • Ovarian cancer • Response to therapy • Pegylated liposomal doxorubicin Topotecan ABSTRACTPurpose. To examine early changes in CA125 relative to objective response in patients with recurrent ovarian cancer treated with pegylated liposomal doxorubicin (PLD) or topotecan and to compare the CA125 trends between the two chemotherapeutics. Patients and Methods. Patients with recurrent ovarian cancer, all of whom had measurable or evaluable disease, were randomized to receive 50 mg/m 2 PLD every 28 days (n ‫؍‬ 239) or 1.5 mg/m 2 topotecan for 5 days every 21 days (n ‫؍‬ 235) as part of a previously reported multicenter study. CA125 measurements were obtained prior to therapy and with each cycle of administration. Assessable patients underwent radiographic evaluation for response after two cycles of therapy. Objective responses were compared to trends in CA125 values at the end of cycles 1 and 2. CA125 changes were categorized as baseline (؎10%), ؎10%-25% variance, and >25% variance.Results. Among patients treated with PLD, 50% of complete responders (CR) and 41% of partial responders (PR) had increases in CA125 from baseline to cycle 1. Increases in CA125 were also seen in topotecantreated patients; however, fewer patients had increases (20% and 8%, respectively). Overall, 15% of responding patients (CR ؉ PR) receiving PLD and 6% receiving topotecan had elevated CA125 after two cycles of therapy. For those patients achieving a partial response, 19% of PLD-treated patients and 8% of topotecantreated patients had CA125 levels above baseline at cycle 2.Conclusions. Considerable intrapatient variation in CA125 values is present among responding patients. Early increases in CA125 may not predict ultimate outcome, especially in PLD-treated patients. The Oncologist

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“…The information may be used to decide whether to continue or end a therapy or to initiate a new treatment. Tumor marker assessment adjusted to the random analytical and biological variation has been suggested as a relevant monitoring tool for surveillance of breast and ovarian cancer (69,70 ). At present, there are no reports from clinical trials on the practicability of this method in prostate cancer, probably because the procedure requires considerable effort if performed manually.…”

Section: Discussionmentioning

confidence: 99%

Biological Variation of Total Prostate-Specific Antigen: A Survey of Published Estimates and Consequences for Clinical Practice

Sölétormos¹,

et al. 2005

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Background:The objectives of this study were to determine whether a single result for total prostate-specific antigen (tPSA) can be used confidently to guide the need for prostate biopsy and by how much serial tPSA measurements must differ to be significant. tPSA measurements include both analytical and biological components of variation. The European Group on Tumor Markers conducted a literature survey to determine both the magnitude and impact of biological variation on single, the mean of replicate, and serial tPSA measurements. Methods: The survey yielded 27 studies addressing the topic, and estimates for the biological variation of tPSA could be derived from 12 of these studies. Results: The mean biological variation was 20% in the concentration range 0.1-20 g/L for men over 50 years. The biological variation means that the one-sided 95% confidence interval (CI) of the dispersion for a single tPSA

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Serum tumour marker CA 125 in monitoring of ovarian cancer during first-line chemotherapy

Cited by 57 publications

References 35 publications

Lack of reliability of CA125 response criteria with anti‐VEGF molecularly targeted therapy

Lack of reliability of CA125 response criteria with anti‐VEGF molecularly targeted therapy

Early Changes in CA125 After Treatment with Pegylated Liposomal Doxorubicin or Topotecan Do Not Always Reflect Best Response in Recurrent Ovarian Cancer Patients

Biological Variation of Total Prostate-Specific Antigen: A Survey of Published Estimates and Consequences for Clinical Practice

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