Systematic Review of Monitoring Criteria to Interpret CA125 Increments during First-Line Chemotherapy and the Subsequent Follow-Up Period among Patients with Advanced Epithelial Ovarian CancerSuher Othman Abu Hassan1*, Dorte L Nielsen2, Malgorzata K Tuxen2, Robert C Bast Jr3 and Gyorgy Soletormos1
- *Corresponding Author:
- Suher Othman Abu Hassan, MD
Department of Clinical Biochemistry
University of Copenhagen North Zealand Hospital
Dyrehavevej 29, DK-3400, Hillerød, Denmark
Tel: +45 48 29 48 29; +45 48 29 69 92
E-mail: [email protected]
Received date August 31, 2015; Accepted date September 23, 2015; Published date September 29, 2015
Citation: Abu Hassan SO, Nielsen DL, Tuxen MK, Jr Bast RC, Soletormos G (2015) Systematic Review of Monitoring Criteria to Interpret CA125 Increments during First-Line Chemotherapy and the Subsequent Follow-Up Period among Patients with Advanced Epithelial Ovarian Cancer. J Oncol Med & Pract 1:101. doi:10.4172/jomp.1000101
Copyright: © 2015 Abu Hassan SO, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Optimal clinical management of ovarian cancer patients requires prompt and accurate determination of whether primary or recurrent disease is responding to chemotherapy. If CA125 is to fill this need, we must understand the design and outcomes of clinical trials that have established a correlation between CA125 levels and growth or shrinkage of tumor burden. It is particularly important to define the magnitude of changes in CA125 concentrations that indicate cancer growth and prompt cessation of ineffective therapy. Objective: To review clinical trials which test the ability of CA125 to monitor ovarian cancer growth during chemotherapy for primary disease and detection of recurrence. Methods: The Medline and Embase databases were searched for original articles published in English between January 1982 and May 2014 that evaluated the utility of CA125 for monitoring ovarian cancer growth. Results: CA125 was evaluated in 13 reports during primary therapy and in eight reports during subsequent follow-up. CA125 sensitivity for detecting tumor growth was not reported consistently, but could be calculated from data provided in the articles. During primary therapy, the median sensitivity for recurrence was 60% (range 33%-95%) and during follow-up the median sensitivity was 85% (range 62%-93%). Conclusion: Consistent criteria for indicating disease progression with CA125 could not be defined due to differences in trial design and selection of patients. The most promising criteria should be re-evaluated under similar and standardized conditions. Computer simulation models and change point algorithms may aid in identifying CA125 assessment criteria to be further validated in prospective clinical trials.