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#611 Correlation between KELIM and CRS score in women with advanced ovarian cancer treated with neoadjuvant chemotherapy and interval debulking surgery
  1. Mara Mantiero1,
  2. Maggie Polignano1,
  3. Marta Bini1,
  4. Salvatore Lopez1,
  5. Alessandra Russo1,
  6. Biagio Paolini1,
  7. Luca Porcu2,
  8. Francesco Raspagliesi1 and
  9. Monika Ducceschi1
  1. 1National Cancer Institute of Milan, Milano, Italy
  2. 2Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK


Introduction/Background Advanced ovarian carcinomas (AOC) not amenable to up-front surgery are treated with neoadjuvant chemotherapy (NACT) before interval debulking surgery (IDS). Based on a semi-mechanistic model, the CA125 ELIMination rate constant K (KELIM) is a reproducible indicator of the tumor-primary chemosensitivity: KELIM >1 is linked with good response to platinum and favorable prognosis. The 3-tier system chemotherapy response score (CRS) is a scoring system based on post-NACT histopathological evaluation, with significant correlation to progression free survival and mixed results for overall survival.

Methodology This is a monocentric retrospective case series. We recorded KELIM (3 CA125 values during the first 100 days of NACT with Carboplatin AUC5 plus Paclitaxel 175 mg/mq q21) and CRS score (1: minimal response; 2: moderate response with residual neoplastic foci; 3: complete or near-complete response, with no residual neoplastic cells or minimal residual up to 2 mm in maximum size). The ordinal logistic regression model was used to detect and estimate statistical correlation between KELIM and CRS.

Results From 11/2019 to 11/2022, 29 women with AOC were treated with NACT followed by IDS at National Cancer Institute of Milano. Median age was 60,5(53–80) years. All patients had a high-grade serous carcinoma; 62% patients had BRCA 1/2 mutations. All patients performed at least 3 cycles of NACT and underwent IDS within 30 days to the end of CT. Six (21%), 16(55%) and 7(24%) patients had CRS equal to 1, 2 and 3 respectively. For the three groups the median value of KELIM was respectively 0.41, 1.07 and 1.92 (Odds Ratio: 10.5, p-value: 0.002).

Conclusion Although the case series was small, we detected a straight correlation between KELIM and CRS in neoadjuvant setting. The tumor chemosensitivity assessed by KELIM during NACT could be a decision-making factor to consider before IDS. Mathematical modeling of KELIM is feasible and reproducible in real life.

Disclosures No disclosure to declare

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