Confirmation of the utility of the CA-125 elimination rate (KELIM) as an indicator of the chemosensitivity in advanced-stage ovarian cancer in a “real-life setting”
- Author:
Lilian van WAGENSVELD
1
;
Olivier COLOMBAN
;
Maaike A. VAN DER AA
;
Gilles FREYER
;
Gabe S. SONKE
;
Roy F.P.M. KRUITWAGEN
;
Benoit YOU
Author Information
- Publication Type:Original Article
- From:Journal of Gynecologic Oncology 2024;35(3):e34-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:The modeled CA-125 ELIMination rate constant K (KELIM) has been validated as a marker of response to chemotherapy in >12,000 patients with advanced epithelial ovarian carcinoma (EOC) treated in first-line setting enrolled in >12 clinical trials. Patient KELIM is calculable online https://www.biomarker-kinetics.org/presentation. The objective was to investigate the prognostic value of KELIM in a large real-life national cancer registry with non-selected patients.
Methods:We investigated 4,025 EOC patients from the Netherlands Cancer Registry treated with neoadjuvant chemotherapy (NACT) ± followed by interval debulking surgery (IDS).Patient KELIM values were calculated in patients with ≥ 3 CA-125 measurements during NACT. KELIM was standardized with a pre-specified cut-off and scored as unfavorable/ favorable (<1.0/≥1.0). KELIM’s prognostic value regarding radiological response, completeness of IDS, progression-free survival (PFS), and overall survival (OS) was assessed using univariate/multivariate analyses.
Results:The data from 1,582 patients treated with heterogeneous chemotherapy regimens and sequences were assessable. KELIM was prognostic for radiological response and the likelihood of complete IDS after NACT (odds ratio=2.59; 95% confidence interval [CI]=2.04– 3.29). Moreover, KELIM was independently associated with PFS (hazard ratio [HR]=0.76;95% CI=0.66–0.87), and OS (HR=0.79; 95% CI=0.69–0.91). Combining KELIM with the completeness of the IDS resulted in 3 prognostic groups (satisfactory, intermediate, and poor) with significant OS differences, namely a good, intermediate, and poor survival respectively.
Conclusion:The value of KELIM, as a pragmatic indicator of response to chemotherapy, was maintained in a large real-life population-based cohort, highlighting its applicability in routine conditions.
