Measure of CA-125 Elimination May Guide Interval Debulking Surgery Selection in High-Grade Serous Ovarian Cancer
Change in treatment for cancer often occurs when conventional treatment protocols are challenged. Ovarian cancer survival is determined by the completeness of initial surgical excision. It is now usual for this surgery to be preceded by chemo in a procedure called neoadjuvant therapy (neo).
This article looks at whether all patients who have neo need to have surgery, measuring the speed at which the marker; CA125 is eliminated, shown by testing blood serum. The rate of elimination is called KELIM, the patient group (254 women), fell into two groups those who had high KELIM (90 women, i.e. good responders), and those who did not.
For patients with high KELIM, debulking surgery was not done in the immediate post chemo stage; those who responded slowly to neo had immediate surgery post chemo. Patients with high KELIM scores and who did not have surgery showed no significant disadvantage in overall survival and progression free survival when compared to the other group. When the possible mortality and morbidity of cancer surgery is taken into consideration the importance of this finding increases.
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