title: Predictive value of serum CA-125 levels in patients with persistent or recurrent epithelial ovarian cancer or peritoneal cancer treated with bevacizumab on a Gynecologic Oncology Group phase II trial.
abstract: OBJECTIVE
  To compare two methods of determining therapeutic response and disease progression - modified Gynecologic Cancer Intergroup (GCIG) criteria based on CA-125 and Radiographic Evaluation Criteria in Solid Tumors (RECIST), in a phase II trial of bevacizumab for patients with recurrent or persistent epithelial ovarian and peritoneal carcinoma.
  
  
  METHODS
  Patients were treated with bevacizumab 15 mg/kg every 21 days. Modified GCIG definitions of progression and response were retrospectively applied and compared to RECIST-defined progression and response. The prognostic significance of CA-125- and RECIST-defined responses and progressions were explored.
  
  
  RESULTS
  Sixty-two patients were evaluable by RECIST, 59 for progression by CA-125, and 45 for response by CA-125. Median progression-free survival (PFS) by RECIST and progression-free interval (PFI) by CA-125 were 4.7 and 5.2 months respectively. However, 12.9% of those with CA-125 defined progression remained progression-free according to RECIST for at least 8 months. Thirteen of 62 patients (21%) had response by RECIST and 14/45 (31%) by CA-125. Time dependent analyses indicated that progression by CA-125 was associated with a 5.2 fold increased risk of progression by RECIST, and response by CA-125 had a 5 fold decrease in risk of progression by RECIST. Landmark and time dependent analyses showed prognostic value of responses by CA-125 and RECIST.
  
  
  CONCLUSIONS
  In this study, disease assessment by RECIST and CA-125 appears to correlate in general. However, approximately 10% of patients might demonstrate progression earlier by CA-125.
authors.affiliation: Division of Gynecologic Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, Orange, CA 92868, USA.
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Randall
authors.forename: Michael W
authors.initials: MW
authors.lastname: Sill
authors.forename: Robert A
authors.initials: RA
authors.lastname: Burger
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Monk
authors.forename: Barbara
authors.initials: B
authors.lastname: Buening
authors.forename: Joel I
authors.initials: JI
authors.lastname: Sorosky
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D018394:CA-125 Antigen / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy*; D010534:Peritoneal Neoplasms / Q000097:blood* / Q000188:drug therapy*; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D018394:CA-125 Antigen; D000068258:Bevacizumab