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CA-125 Response Patterns in Patients With Recurrent Ovarian Cancer Treated With Pegylated Liposomal Doxorubicin (PLD)
  1. Ana Oaknin, MD*,
  2. Pilar Barretina, MD,
  3. Xavier Pérez, MD,
  4. Laura Jimenez, MD,
  5. Montserrat Velasco, MD,
  6. Maria Alsina, MD,
  7. Joan Brunet, MD,
  8. Josep Ramon GermÀ, MD and
  9. Miguel Beltran, MD
  1. *Oncology Department, Vall d'Hebron University Hospital, Barcelona;
  2. Institut Català d'Oncología, Hospital Josep Trueta, Girona; and
  3. Institut Català d'Oncología, Hospital Duran i Reynals L'Hospitalet, Barcelona, Spain.
  1. Address correspondence and reprint requests to Ana Oaknin, MD, Gynecology Cancer Unit, Oncology Department, Vall d'Hebron University Hospital, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. E-mail: amoaknin{at}


Introduction: In recurrent ovarian cancer, CA-125 could be the only objective response criteria. This study analyzes response patterns regarding CA-125 in responders versus nonresponders and determines whether a specific cutoff value for CA-125 could predict clinical response, compared with response evaluation criteria in solid tumors, in patients receiving pegylated liposomal doxorubicin (PLD).

Methods: Sixty-eight patients were identified, 78% were platinum resistant. Relative changes in CA-125 values were calculated, and response was defined as higher than 50% reduction in CA-125 from baseline. Receiver operating characteristic (ROC) curves were constructed based on CA-125 value after the first cycle of PLD to evaluate the most precise cutoff point for the decision model predicting response.

Results: Fifty-three patients were assessable for response: 16 patients responded and 37 did not; the median increase of CA-125 was 0.20 (−63; 312) and 52 (−29; 620), respectively. Our ROC curve generated a cutoff value with a sensitivity of 35% (positive test, the proportion of patients who will not respond) and a predictive positive value of 80%. According to the predictive positive value, 20% of the responder patients will be identified as nonresponders; P = 0.025.

Conclusions: Our ROC analysis did not demonstrate any reliable CA-125 cutoff on response. Discontinuation of the therapy before cycle 3 may exclude some patients who will benefit from PLD.

  • CA-125
  • Ovarian cancer
  • Pegylated liposomal doxorubicin
  • Recurrent

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