Τίτλος:
Poor concordance between CA-125 and RECIST at the time of disease progression in patients with platinum-resistant ovarian cancer: Analysis of the AURELIA trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Data on CA-125 as a predictor of disease progression (PD) in ovarian cancer come predominantly from patients with platinum-sensitive disease receiving chemotherapy alone. We assessed concordance between CA-125-defined and RECIST-defined PD using data from the Gynecologic Cancer InterGroup (GCIG) randomized phase III AURELIA trial in platinum-resistant ovarian cancer (PROC). Patients and methods: Patients with PROC were randomized to receive single-agent chemotherapy with or without bevacizumab. PD by CA-125 was defined according to GCIG criteria (except that confirmatory CA-125 measurement was not required). This exploratory analysis included patients with RECIST PD and a CA-125 reading ≤28 days before and ≤21 days after RECIST-defined PD. Results: Of 218 eligible patients, only 94 (43%, 95% confidence interval 36% to 50%) had concordant RECIST and CA-125 PD status (42% in the chemotherapy-alone arm; 45% in the bevacizumab combination arm, P = 0.6). There was no evidence of CA-125-defined PD in the remaining 124 patients despite PD according to imaging. There were no significant differences in baseline characteristics between patients with PD defined by both RECIST and CA-125 and those with RECIST-only PD. CA-125 was even less sensitive in detecting PD in patients with early (<8 weeks after randomization) compared with later RECIST-defined PD (69% versus 53%, respectively, not meeting CA-125 criteria; P = 0.053). There was no significant difference in survival after PD in patients with concordant PD by RECIST and CA-125 versus those with PD only by RECIST. We validated our findings in an independent study population of PROC. Conclusions: In this platinum-resistant population, PD was typically detected earlier by imaging than by CA-125, irrespective of bevacizumab treatment. Disease status by CA-125 at the time of PD was not prognostic for overall survival. Regular radiologic assessment as well as symptom benefit assessment should be considered during PROC follow-up. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Συγγραφείς:
Lindemann, K.
Kristensen, G.
Mirza, M.R.
Davies, L.
Hilpert, F.
Romero, I.
Ayhan, A.
Burges, A.
Rubio, M.J.
Raspagliesi, F.
Huizing, M.
Creemers, G.-J.
Lykka, M.
Lee, C.K.
Gebski, V.
Pujade-Lauraine, E.
Περιοδικό:
Annals of Oncology
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
bevacizumab; CA 125 antigen; carboplatin; doxorubicin; paclitaxel; platinum derivative; topotecan; antineoplastic agent; CA 125 antigen; platinum, Article; cancer grading; cancer prognosis; cancer staging; computer assisted tomography; controlled study; disease course; human; major clinical study; multiple cycle treatment; ovary cancer; overall survival; phase 3 clinical trial; priority journal; randomized controlled trial; recurrent disease; adult; aged; clinical trial; disease exacerbation; disease free survival; drug resistance; female; genetics; middle aged; ovary tumor; pathology; prognosis; response evaluation criteria in solid tumors; tumor recurrence, Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; CA-125 Antigen; Disease Progression; Disease-Free Survival; Doxorubicin; Drug Resistance, Neoplasm; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Ovarian Neoplasms; Platinum; Prognosis; Response Evaluation Criteria in Solid Tumors
DOI:
10.1093/annonc/mdw238
