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CA125 Nadir Values As a Prognostic Factor in Epithelial Ovarian Cancer

Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey

Ozden Altundag

Houston, TX

Paolo Morandi

Department of Medical Oncology, S. Bortolo General Hospital, Vicenza, Italy

Mehmet Gunduz

Department of Otolaryngology, Graduate School of Medicine and Dentistry, Okayama University, Okayama, Japan

To the Editor:

We read with great interest the article by Placido et al.¹ In their randomized trial, they investigated the efficacy of topotecan as consolidation treatment in patients with advanced ovarian cancer who responded to first-line standard chemotherapy of carbolatin and paclitaxel. After carboplatin and paclitaxel, 87% reached a clinical complete response, and 13% achieved a partial response. These researchers found no significant difference in progression-free survival between patients receiving topotecan and the observation arms. Recent retrospective analysis of two randomized trials showed that CA125 nadir following chemotherapy for epithelial ovarian cancer is a reproducible predictor of progression-free survival and that the proportion of patients attaining low CA125 nadir values ( 10 U/mL [best], 11 to 20 U/mL, and 21 to 30 U/mL [worst]) was better than complete response at discriminating between treatments of differing efficacy.² Therefore, we suggest that further stratification of patients according to CA125 nadir values is potentially important and may better define the efficacy of topotecan as consolidation therapy in advanced ovarian cancer.

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCES

1. De Placido S, Scambia G, Di Vagno G, et al: Topotecan compared with no therapy after response to surgery and carboplatin/paclitaxel in patients with ovarian cancer: Multicenter Italian Trials in Ovarian Cancer (MITO-1) randomized study. J Clin Oncol 22:2635-2642, 2004[Abstract/Free Full Text]

2. Crawford SM, Paul J, Reed NS, et al: The prognostic significance of the CA 125 nadir in patients that achieve CA 125 response. Proc Am Soc Clin Oncol 22:448, 2004 (abstr 5001)

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Related Reply

• In Reply:
  Sandro Pignata, Francesco Perrone, Massimo Di Maio, Ciro Gallo, and Sabino De Placido
  JCO 2005 23: 2436-2437 [Full Text]

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