Early treatment based on rising CA125 did not improve survival in recurrent ovarian cancer
Although CA125 blood levels are an important initial diagnostic marker for ovarian cancer oncologists have been uncertain about the long-term benefits of frequent testing for such markers in patients in remission until now.
MRC OV05/EORTC 55955 trial results, presented at the 2009 ASCO Annual Meeting, revealed no difference in OS among patients who received early treatment due to elevated CA125 (n=265) and those in whom treatment was delayed until symptoms of relapse presented (n=264).
Lack of an ultimate benefit and prolonged exposure to chemotherapy may actually reduce quality of life, according to Gordon J. Rustin, MD, of the Mount Vernon Cancer Centre in the United Kingdom.
The trial compared 265 women with ovarian cancer in remission after initial chemotherapy who began second-line chemotherapy due to a rise in CA125 and 264 women with rising CA125 who delayed treatment until symptoms of relapse appeared.
In patients with rising CA125 second-line chemotherapy was started an average of 4.9 months earlier, and third-line chemotherapy 4.6 months earlier. However, a lack of OS benefit suggests that this strategy did nothing to prolong survival.
For the first time women can be reassured that there is no benefit to early detection of elevated CA125 levels, and they can be told that even if the CA125 rises chemotherapy can be safely delayed until they have signs or symptoms of tumor recurrence, Rustin said.
He emphasized that CA125 blood testing often causes anxiety among patients and confusion for many physicians and stated that the trial findings give patients more choices during follow-up care. We are giving women a lot more information to cope with their disease, he said. The majority of women, in my experience want that option. by Nicole Blazek
This is a study that could potentially affect the lives of all women with stage III and IV ovarian cancer around the world. This is the kind of research thats often very, very difficult to do far more difficult then testing a new drug and yet it is so very important. Beyond improving the quality of life of women with ovarian cancer, it also has the potential to result in substantial economic savings.
- Eric P. Winer, MD
Chief of the Division of Womens Cancers,
Dana-Farber Cancer Institute
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