Prognostic value of change in CA 125 levels after the first cycle of induction chemotherapy for epithelial ovarian cancers: Results of a multicentric French study

Abstract

16017 Background: CA 125 assays enable treatment-response monitoring in ovarian cancer. Patients and Methods: This multicentric study was performed to assess the predictive value with regard to pathologic complete response at surgical second look and the prognostic value of the serum CA 125 change (=rease [D], 50%, 25%, < 25%ase) after one or two courses of induction chemotherapy (CT) with platinum salts and cyclophosphamide Of the 494 stage IIc - IV patients who were treated at the French Cancer Centres of Dijon, Bordeaux, Toulouse, Rouen, Reims, Nantes, Angers, Saint Cloud, 397 (80.4%d and 382 (77.3%om cancer. Median (range) follow up time was 34 months (3 - 215 months). Among them, 194 patients had a surgical second look. Results: The CA 125 change after the first, the second and the two first CT courses and CA 125 concentration (> or =-1) before the third CT cycle had an univariate prognostic value for overall survival (OS) (p < 0.0001 for both). In Cox models, CA 125 change after the first CT course (p < 0.0001), residual tumour (p = CA 125 concentration before the second CT course (p =and patients’ age (p =were independent prognostic factors for OS. A normal CA 125 before each of the two first CT courses or a CA 125 decrease higher than 50%e first CT course with a CA 125 =-1 before the second CT course identify patients with good prognosis. Both criteria retained a significant value in predicting second-look findings by univariate and multivariate analysis (p < 0.0001). Conclusion: Among well-established prognostic factors in ovarian cancers, the CA 125 change after the first CT course was independent prognostic factors for both achievement of pathological complete response and OS. No significant financial relationships to disclose.