CA-125 response patterns in patients with recurrent ovarian cancer treated with pegylated liposomal doxorubicin (PLD).
BACKGROUND
: In recurrent ovarian cancer, CA-125 could be the only objective response criteria. This study analyzes response patterns regarding CA-125 in responders versus nonresponders and determines whether a specific cutoff value for CA-125 could predict clinical response, compared with response evaluation criteria in solid tumors, in patients receiving pegylated liposomal doxorubicin (PLD).


METHODS
: Sixty-eight patients were identified, 78% were platinum resistant. Relative changes in CA-125 values were calculated, and response was defined as higher than 50% reduction in CA-125 from baseline. Receiver operating characteristic (ROC) curves were constructed based on CA-125 value after the first cycle of PLD to evaluate the most precise cutoff point for the decision model predicting response.


RESULTS
: Fifty-three patients were assessable for response: 16 patients responded and 37 did not; the median increase of CA-125 was 0.20 (-63; 312) and 52 (-29; 620), respectively. Our ROC curve generated a cutoff value with a sensitivity of 35% (positive test, the proportion of patients who will not respond) and a predictive positive value of 80%. According to the predictive positive value, 20% of the responder patients will be identified as nonresponders; P = 0.025.


CONCLUSIONS
: Our ROC analysis did not demonstrate any reliable CA-125 cutoff on response. Discontinuation of the therapy before cycle 3 may exclude some patients who will benefit from PLD.
Gynecology Cancer Unit, Oncology Department, Vall d'Hebron University Hospital, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. amoaknin@vhebron.net
Ana
A
Oaknin
Pilar
P
Barretina
Xavier
X
Pérez
Laura
L
Jimenez
Montserrat
M
Velasco
Maria
M
Alsina
Joan
J
Brunet
Josep Ramon
JR
Germà
Miguel
M
Beltran
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000737:chemistry; D054316:Biomarkers, Pharmacological / Q000097:blood / Q000378:metabolism; D018394:CA-125 Antigen / Q000097:blood*; D018284:Cystadenocarcinoma, Serous / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D004317:Doxorubicin / Q000008:administration & dosage* / Q000737:chemistry; D005260:Female; D006801:Humans; D008081:Liposomes; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D011092:Polyethylene Glycols / Q000737:chemistry; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D012680:Sensitivity and Specificity
D000903:Antibiotics, Antineoplastic; D054316:Biomarkers, Pharmacological; D018394:CA-125 Antigen; D008081:Liposomes; D011092:Polyethylene Glycols; D004317:Doxorubicin