Introduction/Background Evaluation of the utility of HE4 and CA 125 assays in monitoring treatment response before and during treatment, based on the treatment regimen used.
Methodology CA125 and HE4 levels were determined in 65 ovarian cancer patients FIGO III–IV. 33 patients received surgical treatment before systemic therapy (CHTH) (Group1) and 32 patients received neoadjuvant chemoterapy (NACTH) before surgery (Group2). Determination of markers was performed in serum samples by the Roche: Group1 before treatment, after surgery, after 3 and 6 CHTH; Group2 before treatment, after NACTH, surgery and 6 CHTH. For statistical calculations, the Mann-Whitney and Wilcoxon tests were used.
Results HE4 concentrations were significantly higher in patients that were assigned to NACTH both before and after treatment, as compared to HE4 concentrations in group I (P=0.003, P=0.0004). In Group1, after surgery HE4 and CA125 median levels decreased respectively by 67% and 66%, depending on the level of treatment. In Group2, after NACTH, the reduction in marker levels was larger (HE4 84%; CA125 94%). In Group1, a similar decrease in HE4 median by 72% and CA125 by 96% was only observed after 6 CHTH cycles. In Group1, concentrations of HE4 (P=0.001) and CA125 (P=0.003) were significantly lower after surgery vs before treatment and CA125 levels were further reduced, sixth vs third CHTH course. Similar differences were observed in Group2: HE4 (P=0.002) and CA125 (P=0.0001) were significantly lower after NACTH vs. pre-treatment and more reduced after six courses of CHTH: HE4 (P=0.009) and CA125 (P=0.02).
Conclusion At the time of the diagnosis, the median levels of markers HE4 and CA125 are significantly different between patients in the group qualified for NACTH and in patients with advanced ovarian cancer. Observed significant changes in pre-treatment serum concentrations, in particular in the case of HE4 in the schema used, confirm their usefulness in treatment monitoring.
Disclosure Nothing to disclose.
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