1. Confirmation of the utility of the CA-125 elimination rate (KELIM) as an indicator of the chemosensitivity in advanced-stage ovarian cancer in a "real-life setting".
- Author
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van Wagensveld L, Colomban O, van der Aa MA, Freyer G, Sonke GS, Kruitwagen RFPM, and You B
- Subjects
- Humans, Female, Middle Aged, Aged, Adult, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Netherlands, Registries, Prognosis, Neoplasm Staging, Progression-Free Survival, Chemotherapy, Adjuvant, Aged, 80 and over, Biomarkers, Tumor blood, CA-125 Antigen blood, Ovarian Neoplasms drug therapy, Ovarian Neoplasms pathology, Ovarian Neoplasms mortality, Ovarian Neoplasms therapy, Carcinoma, Ovarian Epithelial drug therapy, Carcinoma, Ovarian Epithelial pathology, Carcinoma, Ovarian Epithelial mortality, Carcinoma, Ovarian Epithelial therapy, Neoadjuvant Therapy methods, Cytoreduction Surgical Procedures
- Abstract
Objective: The modeled CA-125 ELIMination rate constant K (KELIM) has been validated as a marker of response to chemotherapy in >12,000 patients with advanced epithelial ovarian carcinoma (EOC) treated in first-line setting enrolled in >12 clinical trials. Patient KELIM is calculable online https://www.biomarker-kinetics.org/presentation. The objective was to investigate the prognostic value of KELIM in a large real-life national cancer registry with non-selected patients., Methods: We investigated 4,025 EOC patients from the Netherlands Cancer Registry treated with neoadjuvant chemotherapy (NACT) ± followed by interval debulking surgery (IDS). Patient KELIM values were calculated in patients with ≥ 3 CA-125 measurements during NACT. KELIM was standardized with a pre-specified cut-off and scored as unfavorable/favorable (<1.0/≥1.0). KELIM's prognostic value regarding radiological response, completeness of IDS, progression-free survival (PFS), and overall survival (OS) was assessed using univariate/multivariate analyses., Results: The data from 1,582 patients treated with heterogeneous chemotherapy regimens and sequences were assessable. KELIM was prognostic for radiological response and the likelihood of complete IDS after NACT (odds ratio=2.59; 95% confidence interval [CI]=2.04-3.29). Moreover, KELIM was independently associated with PFS (hazard ratio [HR]=0.76; 95% CI=0.66-0.87), and OS (HR=0.79; 95% CI=0.69-0.91). Combining KELIM with the completeness of the IDS resulted in 3 prognostic groups (satisfactory, intermediate, and poor) with significant OS differences, namely a good, intermediate, and poor survival respectively., Conclusion: The value of KELIM, as a pragmatic indicator of response to chemotherapy, was maintained in a large real-life population-based cohort, highlighting its applicability in routine conditions., Competing Interests: Y.B. received personal fees for advisory board participation from AZ, GSK, NOVARTIS, BAYER, ROCHE, CLOVIS, AMGEN, MSD, ECS Progastrin. Furthermore, Y.B. received personal fees from Lyon University Hospital and Lyon University. S.G.S. reports institutional research support from AstraZeneca, Merck, Novartis, and Roche. All other authors declare no competing interests., (© 2024. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology.)
- Published
- 2024
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