CA 125 half-life and CA 125 nadir during induction chemotherapy are independent predictors of epithelial ovarian cancer outcome: results of a French multicentric study.
BACKGROUND
CA 125 assays enable treatment-response monitoring in ovarian cancer.


METHODS
A multicentric study of CA 125 kinetics under induction chemotherapy was performed in 631 patients. CA 125 half-life was calculated by mono-compartmental logarithmic regression. Nadir CA 125 concentration and time to nadir were also studied. Survival analyses for disease-free survival (DFS) and overall survival (OS) used univariate (Kaplan-Meier) and multivariate (Cox) models.


RESULTS
For 553 stage IIC-IV patients, 459 (83.0%) relapsed and 444 (80.3%) died from cancer. Median (range) follow up time was 32 months (2-214 months). Median (range) for CA 125 kinetics were: 263 kU/l (5-52000 kU/l) before 1st course, 15.8 days (4.5-417.9 days) for CA 125 half-life, 16 kU/l (3-2610 kU/l) for nadir and 85 days (0-361 days) for time to nadir. Pre-chemotherapy CA 125, its half-life, nadir concentration and time to nadir all had a univariate prognostic value for DFS and OS (P<0.0001). In Cox models, CA 125 half-life, residual tumour (P<0.0001 for both), nadir concentration (P=0.0002) and stage (P=0.0118) were the most powerful prognostic factors for DFS. For OS, the significant variables were similar, with age ranking last (P=0.0319).


CONCLUSIONS
Among well-established prognostic factors in ovarian cancers, CA 125 half-life and nadir concentration bear a strong and independent prognostic value.
Riedinger
J M
JM
Laboratoire de Biologie Médicale, Centre GF. Leclerc, Dijon, France. jriedinger@dijon.fnclcc.fr
Wafflart
J
J
Ricolleau
G
G
Eche
N
N
Larbre
H
H
Basuyau
J P
JP
Dalifard
I
I
Hacene
K
K
Pichon
M F
MF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000378:metabolism; D018394:CA-125 Antigen / Q000032:analysis* / Q000378:metabolism; D002277:Carcinoma / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006207:Half-Life; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen