title: 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.
abstract: 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.
authors.affiliation: Laboratoire de Biologie Médicale, Centre GF. Leclerc, Dijon, France. jriedinger@dijon.fnclcc.fr
authors.forename: J M
authors.initials: JM
authors.lastname: Riedinger
authors.forename: J
authors.initials: J
authors.lastname: Wafflart
authors.forename: G
authors.initials: G
authors.lastname: Ricolleau
authors.forename: N
authors.initials: N
authors.lastname: Eche
authors.forename: H
authors.initials: H
authors.lastname: Larbre
authors.forename: J P
authors.initials: JP
authors.lastname: Basuyau
authors.forename: I
authors.initials: I
authors.lastname: Dalifard
authors.forename: K
authors.initials: K
authors.lastname: Hacene
authors.forename: M F
authors.initials: MF
authors.lastname: Pichon
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen