abstract: Predictive value of serum CA-125 levels in patients with persistent or recurrent epithelial ovarian cancer or peritoneal cancer treated with Bevacizumab (Avastin) Gynecologic Oncology Group phase II trial

Purpose

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.

Results

Sixty-two patients were evaluable by RECIST, 59 for progression by CA-125, and 45 for response by CA-125..........

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.

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Highlights

► CA125-defined response and progression were assessed for women with recurrent ovarian cancer.
► CA125 and RECIST-defined response and progression correlated in most cases, but CA125 progression significantly preceded RECIST in 8 cases.
► CA125-defined response to bevacizumab was associated with a statistically significant correlation with overall survival.

Access : CA-125 can be part of the tumour evaluation criteria in ovarian cancer trials: experience of the GCIG CALYPSO trial : British Journal of Cancer

Background:

CA-125 as a tumour progression criterion in relapsing ovarian cancer (ROC) trials remains controversial. CALYPSO is a large randomised trial incorporating CA-125 (GCIG criteria) and symptomatic deterioration in addition to Response Evaluation Criteria in Solid Tumours (RECIST) criteria (radiological) to determine progression.

......In patients with CA-125 first progression who subsequently progressed radiologically, a delay of 2.3 months was observed between the two progression types......

Conclusion:

CA-125 and radiological tests performed similarly in determining progression with C-PLD (carboplatin-pegylated liposomal doxorubicin) or C-P (carboplatin–paclitaxel). Additional follow-up with CA-125 measurements was not associated with overtreatment.

New lesions versus growth of existing disease: Does it impact prognosis? ASCO Meeting Abstract

Note: this study concerns the clinical criteria for evidence of progressive/new disease 

Conclusions:

In 9,741 (patients), survival after development of new lesions as the sole reason for progression did not significantly differ from patients with other reasons of PD (progressive disease). These findings give further validation to the use of new lesions as a classifier of PD according to established criteria. (RECIST)

Background:

Clinical trials use established criteria (RECIST or WHO) to determine objective tumor behavior on therapy. Participants are labeled to have progressive disease (PD) and are taken off study if they meet specific parameters of increase in size of their known lesions, but can also be labeled as PD if they develop new lesions without meeting criteria for progression in known lesions. To determine whether there are outcome disparities among these patients, we explored survival differences by reason of progression among patients who developed PD on study using data from the phase III Intergroup trial N9741 which compared IFL, FOLFOX4, and IROX as first-line therapy in advanced colorectal cancer (Goldberg JCO 2004).

abstract: Correlation between CA-125 serum level and response by RECIST in a phase III recurrent ovarian cancer study.

OBJECTIVES:

To evaluate in a large phase III recurrent ovarian cancer trial (OVA-301): 1) the concordance between CA-125 level vs. best overall response (OR) and progression-free survival (PFS) determined by radiological assessment 2) the impact of early CA-125 changes over the subsequent radiological response, and 3) the prognostic value of CA-125 response and CA-125 PFS to predict radiological response and PFS.