title: CA125 level association with chemotherapy toxicity and functional status in older women with ovarian cancer.
abstract: OBJECTIVE
  Older women with ovarian cancer have increased cancer-related mortality and chemotherapy toxicity. CA125 is a sensitive biomarker for tumor burden. The study evaluates the association between CA125, geriatric assessment (GA), and treatment toxicity.
  
  
  METHODS
  This is a secondary subset analysis of patients 65 years or older with ovarian cancer accrued to a multicenter prospective study that developed a predictive toxicity score for older adults with cancer. Clinical and geriatric covariates included sociodemographics, GA (comorbidity, social support, functional, nutritional, psychological, cognitive status), treatment, and laboratory studies. Using bivariate analyses, we determined the association of abnormal CA125 (≥35 U/mL) with baseline GA, grades 3 to 5 toxicity (Common Terminology Criteria for Adverse Events version 3), dose adjustments, and hospitalization. Logistic regression analysis was used to check for potential confounder for association between CA125 and chemotherapy toxicity.
  
  
  RESULTS
  Fifty-one (10%) of 500 patients accrued to the primary study had a diagnosis of ovarian (92%), peritoneal (4%), or fallopian tube (4%) cancer. Median age was 72 years (range, 65-86 years). Forty-six patients (90%) had stage III-IV disease. Twenty-three patients (45%) received first-line chemotherapy, and 34 (67%) received platinum-doublet therapy. Thirty-six (71%) had an abnormal CA125. Grades 3 to 5 toxicity occurred in 19 patients (37%). Abnormal CA125 was associated with assistance with instrumental activities of daily living (P < 0.05), lower performance status (P = 0.05), grades 3 to 5 toxicity (P = 0.03), nonheme toxicity (P = 0.04), and dose reductions (P = 0.01). No association between CA125 level and total toxicity score was observed.
  
  
  CONCLUSIONS
  Among older women with ovarian cancer, abnormal CA125 was associated with poor pretreatment functional status and an increased probability of chemotherapy toxicity and dose reduction.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Won
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.forename: Tao
authors.initials: T
authors.lastname: Feng
authors.forename: Supriya
authors.initials: S
authors.lastname: Mohile
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owusu
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Klepin
authors.forename: Cary P
authors.initials: CP
authors.lastname: Gross
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Lichtman
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gajra
authors.forename: William P
authors.initials: WP
authors.lastname: Tew
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018394:CA-125 Antigen / Q000378:metabolism*; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D064420:Drug-Related Side Effects and Adverse Reactions; D005185:Fallopian Tube Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D000068258:Bevacizumab; D016190:Carboplatin; D002945:Cisplatin