Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Gynecol Oncol. 2020 Aug;158(2):303-308. doi: 10.1016/j.ygyno.2020.04.710. Epub 2020 Jun 2.
This study aimed to evaluate the utility of serum cancer antigen-125 (CA-125) levels to monitor patients with epithelial ovarian cancer (EOC) undergoing immune checkpoint inhibitor (ICI) therapy.
This was a single-center retrospective review of all patients with EOC who were treated with ICI therapy from January 2013 to May 2017. This study compared the percentage change in baseline CA-125 in patients who had clinical benefit, defined as complete response, partial response, or stable disease by RECIST 1.1, with duration ≥24 weeks, versus those who did not. The groups were compared by Wilcoxon rank-sum test.
Fifty-nine (66%) of 89 patients who underwent ICI therapy had CA-125 data at baseline and during treatment. Of those who derived clinical benefit, 11/15 (73%) experienced an increase in CA-125 from baseline to end of treatment. Of those who did not derive clinical benefit, 36/44 (82%) experienced a CA-125 increase (p = 0.48). The average % increase from baseline to within 12 weeks of treatment initiation for patients with and without clinical benefit was 34% and 195%, respectively (p = 0.008).
Our analysis demonstrates a statistically significant difference in the magnitude of increase in CA-125 levels within the first 12 weeks of treatment between patients who achieved clinical benefit and those who did not. However, both groups of patients were equally likely to experience an increase in CA-125 within 12 weeks. These findings suggest that physicians should apply caution when using early CA-125 data to guide treatment decisions for patients with EOC undergoing ICI therapy.
本研究旨在评估血清肿瘤标志物 125（CA-125）水平在监测接受免疫检查点抑制剂（ICI）治疗的上皮性卵巢癌（EOC）患者中的作用。
这是一项单中心回顾性研究，纳入了 2013 年 1 月至 2017 年 5 月期间接受 ICI 治疗的所有 EOC 患者。本研究比较了 RECIST 1.1 定义的完全缓解、部分缓解或疾病稳定且持续时间≥24 周的患者与未获得临床获益的患者的基线 CA-125 百分比变化，后者定义为疾病进展。采用 Wilcoxon 秩和检验比较两组。
89 例接受 ICI 治疗的患者中有 59 例（66%）具有基线和治疗期间的 CA-125 数据。其中，15 例获得临床获益的患者中有 11 例（73%）的 CA-125 从基线到治疗结束时升高。未获得临床获益的 44 例患者中有 36 例（82%）的 CA-125 升高（p=0.48）。基线至治疗开始后 12 周内，有临床获益和无临床获益患者的 CA-125 从基线升高的平均百分比分别为 34%和 195%（p=0.008）。
我们的分析表明，在接受 ICI 治疗的 EOC 患者中，在治疗的前 12 周内，CA-125 水平升高幅度在获得临床获益和未获得临床获益的患者之间存在统计学显著差异。然而，在 12 周内，两组患者的 CA-125 均有可能升高。这些发现表明，医生在使用早期 CA-125 数据来指导接受 ICI 治疗的 EOC 患者的治疗决策时应谨慎。
