Modeling CA-125 During Neoadjuvant Chemotherapy for Predicting Optimal Cytoreduction and Relapse Risk in Ovarian Cancer

Abstract

Aim: To investigate the prognostic value of modeled CA-125 kinetic parameters regarding surgery outcomes and time to second-line chemotherapy in a population of ovarian cancer patients treated with neoadjuvant chemotherapy followed by interval cytoreduction.

Patients and methods: This retrospective study included consecutive patients with FIGO stage IIIc/IV ovarian cancer treated between 2006 and 2014. We characterized CA-125 kinetics and identified modeled kinetic parameters.

Results: Fifty four patients were included. KELIM (modeled CA-125 elimination rate constant) was an independent predictive parameter of optimal cytoreduction (OR=0.18; 95% CI=0.04-0.69; p=0.02). In the optimal cytoreduction population (40 patients, 74.1%), E₅₀ (concentration producing 50% of the maximum chemotherapy effect) was a significant prognostic parameter regarding time to second-line chemotherapy (HR=0.38; 95% CI=0.173-0.854; p=0.019).

Conclusion: We identified CA-125 modeled kinetic parameters during neoadjuvant chemotherapy harboring potential predictive values regarding the likelihood of optimal cytoreduction, along with time to second-line chemotherapy in optimally-cytoreduced patients.

Keywords: CA-125 kinetics; Epithelial ovarian cancer; cytoreduction prediction; mathematical modeling; neoadjuvant chemotherapy; second-line chemotherapy.