Coleman Robert L, Gordon Alan, Barter James, Sun Steven, Rackoff Wayne, Herzog Thomas J
The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA.
Oncologist. 2007 Jan;12(1):72-8. doi: 10.1634/theoncologist.12-1-72.
To examine early changes in CA125 relative to objective response in patients with recurrent ovarian cancer treated with pegylated liposomal doxorubicin (PLD) or topotecan and to compare the CA125 trends between the two chemotherapeutics.
Patients with recurrent ovarian cancer, all of whom had measurable or evaluable disease, were randomized to receive 50 mg/m2 PLD every 28 days (n = 239) or 1.5 mg/m2 topotecan for 5 days every 21 days (n = 235) as part of a previously reported multicenter study. CA125 measurements were obtained prior to therapy and with each cycle of administration. Assessable patients underwent radiographic evaluation for response after two cycles of therapy. Objective responses were compared to trends in CA125 values at the end of cycles 1 and 2. CA125 changes were categorized as baseline (+/-10%), +/- 10%-25% variance, and > 25% variance.
Among patients treated with PLD, 50% of complete responders (CR) and 41% of partial responders (PR) had increases in CA125 from baseline to cycle 1. Increases in CA125 were also seen in topotecan-treated patients; however, fewer patients had increases (20% and 8%, respectively). Overall, 15% of responding patients (CR + PR) receiving PLD and 6% receiving topotecan had elevated CA125 after two cycles of therapy. For those patients achieving a partial response, 19% of PLD-treated patients and 8% of topotecan-treated patients had CA125 levels above baseline at cycle 2.
Considerable intrapatient variation in CA125 values is present among responding patients. Early increases in CA125 may not predict ultimate outcome, especially in PLD-treated patients.
研究复发卵巢癌患者接受聚乙二醇化脂质体阿霉素（PLD）或拓扑替康治疗时，CA125相对于客观缓解的早期变化，并比较两种化疗药物之间的CA125变化趋势。
复发卵巢癌患者，所有患者均有可测量或可评估的疾病，作为先前报道的多中心研究的一部分，随机接受每28天50mg/m² PLD（n = 239）或每21天1.5mg/m²拓扑替康治疗5天（n = 235）。在治疗前和每个给药周期进行CA125测量。可评估患者在两个治疗周期后接受影像学评估以确定缓解情况。将客观缓解与第1和第2周期末的CA125值趋势进行比较。CA125变化分为基线（±10%）、±10%-25%变化和>25%变化。
在接受PLD治疗的患者中，50%的完全缓解者（CR）和41%的部分缓解者（PR）从基线到第1周期CA125升高。接受拓扑替康治疗的患者中也观察到CA125升高；然而，升高的患者较少（分别为20%和8%）。总体而言，接受PLD治疗的缓解患者（CR + PR）中有15%，接受拓扑替康治疗的患者中有6%在两个治疗周期后CA125升高。对于那些获得部分缓解的患者，接受PLD治疗的患者中有19%，接受拓扑替康治疗的患者中有8%在第2周期时CA125水平高于基线。
缓解患者中CA125值存在相当大的个体内差异。CA125早期升高可能无法预测最终结果，尤其是在接受PLD治疗的患者中。
