REPOST: CA-125: To Monitor or Not to Monitor?: Evidence Against Monitoring CA-125

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CA-125: To Monitor or Not to Monitor?: Evidence Against Monitoring CA-125

 From Medscape Hematology-Oncology

CA-125: To Monitor or Not to Monitor?

For Ovarian Cancer Patients in Remission

Gordon Rustin, MD; Beth Y. Karlan, MD; Maurie Markman, MD

Authors and Disclosures

Posted: 03/08/2012

SGO sets new standards to monitor recurrence of gynecologic cancer more effectively

"The article is “Post treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology recommendations: by Ritu Salani, MD, MBA; Floor J. Backes, MD; Michael Fung Kee Fung, MB, BS; Christine H. Holschneider, MD; Lynn P. Parker, MD; Robert E. Bristow, MD, MBA; and Barbara A. Goff, MD (doi: 10.1016/j.ajog.2011.03.008). It will appear in the American Journal of Obstetrics & Gynecology, Volume 204, Issue 6 (June 2011) published by Elsevier."

Gynecological Cancers. [Methods Mol Biol. 2011]

Abstract

The clinical problems raised in patients presenting with all forms of gynecological malignancy are currently addressed using conventional cross-sectional imaging, usually MRI. In general, F-18 FDG PET-CT has not been shown to have a clinical role in any of these cancers at presentation, although studies are under way to use this form of metabolic imaging to predict prognosis and the response to treatment. Although F-18 FDG PET-CT is superior to conventional imaging techniques, it is only moderately sensitive in demonstrating lymph node metastasis preoperatively, and is inadequate for local staging of patients with endometrial cancer. In ovarian cancer, F-18 FDG PET-CT provides an accurate assessment of the extent of disease, particularly in areas difficult to assess for metastases by CT and MRI such as the abdomen and pelvis, mediastinum, and supraclavicular region. F-18 FDG PET-CT is a sensitive method of detecting pelvic and para-aortic lymph nodal disease in cervical cancer, and appears to be superior to MRI and CT despite the limitations in identifying small foci of disease. In the main, as elsewhere in patients with cancer, the value of PET-CT is in identifying and defining the extent of recurrent disease, in distinguishing between posttreatment fibrosis and recurrence, and possibly in monitoring response to therapy.

full free access: Journal of Oncology — Review Article: Potential Markers for Detection & Monitoring of Ovarian Cancer Feb 8, 2011

  Note:  pdf file


Conclusions and Emerging Trends in Biomarkers for Ovarian Cancer

"The ultimate aim of effective screening techniques is to bring about a reduction in mortality form ovarian cancer. As early detection continues to be vital in ovarian cancer patients, biomarkers may hold the key to unlocking effective screening strategies for the general population. It is also important to identify screening techniques with low false positive rates and high positive predictive value so that the number of negative surgical interventions can be minimized. Since our currently available single markers are not highly sensitive or specific, a combination of markers may be utilized as a profile for risk assessment. The current problem with screening panels is that the improvement in sensitivity usually correlates with a decrease in specificity, making the target positive predictive value hard to obtain. The multimodal screening profiles of the genetic markers could be utilized in the future for risk assessment, early diagnosis, prognosis and response to therapeutic treatment. Recent literature reports state that the screening is only recommended for the high risk population identified as those with a family history of the disease, women with BRCA1 and BRCA2 mutations, or with hereditary non polyposis colorectal cancer. Recent literature reports also emphasize that the different subtypes of ovarian cancer may have different genetic biomarker expression profiles. Current randomized controlled screening trials are directed towards finding the best molecular and genetic markers for the specific histology of the ovarian tumor with the most impact on reduction in morbidity and mortality. The tumor markers identified in these trials may also lead to novel targets for antitumor therapy."

(full free access) Foreword: Today’s discoveries to tomorrow’s care: cancer biomarkers revisited

1) link:  Themed content: Using biomarkers to individualize and monitor cancer therapy - Foreword

2) link: Epigenomics and ovarian carcinoma

Leonel Maldonado, Mohammad Obaidul Hoque

Biomarkers in Medicine, August 2010, Vol. 4, No. 4, Pages 543-570.

(Summary)

 

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abstract : Whole blood-derived miRNA profiles as potential new tools for ovarian cancer screening : British Journal of Cancer

Conclusion:

Our proof-of-principle study strengthens the hypothesis that neoplastic diseases generate characteristic miRNA fingerprints in blood cells. Still, the obtained OvCA-associated miRNA pattern is not yet sensitive and specific enough to permit the monitoring of disease progression or even preventive screening. Microarray-based miRNA profiling from peripheral blood could thus be combined with other markers to improve the notoriously difficult but important screening for OvCA.

JAMA -- Abstract: Effect of Telecare Management on Pain and Depression in Patients With Cancer: A Randomized Trial, July 14, 2010

Conclusion
Centralized telecare management coupled with automated symptom monitoring resulted in improved pain and depression outcomes in cancer patients receiving care in geographically dispersed urban and rural oncology practices.

FDA to Communicate Safety Monitoring Activities to Consumers and Health Care Professionals

FDA to Communicate Safety Monitoring Activities to Consumers and Health Care Professionals
New website will contain safety reports on recently approved drugs, biologics