title: Declining CA-125 in an ovarian cancer patient with progression of measurable disease: a rational hypothesis for discordant results.
abstract: OBJECTIVE
  While a declining CA-125 has been demonstrated to be a useful indicator of response to chemotherapy in ovarian cancer, occasional patients will demonstrate discordant results between the level of this antigen and changes in the size of measurable tumor masses.
  
  
  METHODS
  The patient was seen in the Gynecologic Oncology Program of the Cleveland Clinic Taussig Cancer Center.
  
  
  RESULTS
  This patient exhibited a "major response" by CA-125 criteria, significant shrinkage of multiple peritoneal and perirectal implants, but clear progression of a pelvic side wall mass. The discordant results in this case are likely an example of a "mixed response" to the chemotherapy regimen, with the declining CA-125 corresponding to shrinkage of the responding tumor cell population.
  
  
  CONCLUSIONS
  An evaluation of changes in both the serum CA-125 level and measurable masses may represent a more complete analysis of the status of disease in an individual with ovarian cancer.
authors.affiliation: Cleveland Clinic Taussig Cancer Center, Department of Gynecology/Obstetrics, Department of Hematology/Medical Oncology, The Cleveland Clinic Foundation, Ohio 44195, USA. markmam@ccf.org
authors.forename: M
authors.initials: M
authors.lastname: Markman
authors.forename: A
authors.initials: A
authors.lastname: Kennedy
authors.forename: K
authors.initials: K
authors.lastname: Webster
authors.forename: G
authors.initials: G
authors.lastname: Peterson
authors.forename: B
authors.initials: B
authors.lastname: Kulp
authors.forename: J
authors.initials: J
authors.lastname: Belinson
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D018450:Disease Progression; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen