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

Abstract

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.

METHODS:

In all, 976 patients with platinum-sensitive ROC were randomised to carboplatin-paclitaxel (C-P) or carboplatin-pegylated liposomal doxorubicin (C-PLD). CT-scan and CA-125 were performed every 3 months until progression.

RESULTS:

In all, 832 patients (85%) progressed, with 60% experiencing a first radiological progression, 10% symptomatic progression, and 28% CA-125 progression without evidence of radiological or symptomatic progression. The benefit of C-PLD vs C-P in progression-free survival was not influenced by type of first progression (hazard ratio 0.85 (95% confidence interval (CI): 0.66-1.10) and 0.84 (95% CI: 0.72-0.98) for CA-125 and RECIST, respectively). In patients with CA-125 first progression who subsequently progressed radiologically, a delay of 2.3 months was observed between the two progression types. After CA-125 first progression, median time to new treatment was 2.0 months. In all, 81%of the patients with CA-125 or radiological first progression and 60% with symptomatic first progression received subsequent treatment.

CONCLUSION:

CA-125 and radiological tests performed similarly in determining progression with C-PLD or C-P. Additional follow-up with CA-125 measurements was not associated with overtreatment.

• Authors: J Alexandre, C Brown, D Coeffic, N Raban, J Pfisterer, J Mäenpää, H Chalchal, B Fitzharris, B Volgger, I Vergote, C Pisano, A Ferrero, E Pujade-Lauraine
• Journal: British journal of cancer (Br J Cancer) Vol. 106 Issue 4 Pg. 633-7 (Feb 14 2012) ISSN: 1532-1827 [Electronic] England
• PMID: 22240800 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)

Chemical References

• CA-125 Antigen
• liposomal doxorubicin
• Polyethylene Glycols
• Doxorubicin
• Carboplatin
• Paclitaxel

Topics

• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• CA-125 Antigen (analysis)
• Carboplatin (administration & dosage)
• Disease Progression
• Disease-Free Survival
• Doxorubicin (adverse effects, analogs & derivatives)
• Female
• Humans
• Ovarian Neoplasms (diagnostic imaging, drug therapy)
• Paclitaxel (administration & dosage)
• Polyethylene Glycols (adverse effects)
• Recurrence
• Tomography, X-Ray Computed