Introduction To evaluate the predictive value of CA-125 ELIMination of Rate Constant K (KELIM) on prognosis and duration of long-term bevacizumab maintenance therapy (BMT) in first platinum-sensitive recurrence of ovarian cancer.
Methods We included patients with platinum-sensitive recurrence of ovarian cancer who underwent six cycles of paclitaxel-carboplatin-bevacizumab chemotherapy followed by BMT between 2015 and 2021. To predict the prognosis and duration of long-term BMT (≥10 cycles), we calculated KELIM scores after completion of three cycles of paclitaxel-carboplatin-bevacizumab. Then, we calculated the cut-off value of the KELIM score to predict progression-free interval ≥12 months.
Results A total of 96 patients were included, who consisted of 28 (29%) treated with secondary cytoreductive surgery (SCS) followed by chemotherapy, and 68 (71%) treated with chemotherapy alone. The cut-off value of the KELIM score for predicting PFI ≥12 months was 1.08. (AUC 0.82; sensitivity, 0.75; specificity, 0.76). Although SCS did not affect progression-free survival (PFS) and overall survival (OS), high-KELIM demonstrated better prognosis than low-KELIM in patients treated with SCS (PFS, median, 13.7 vs. 15.4 mons; p=0.04; OS, 21.7 vs. 28.8; p=0.006; figure 1), whereas there was no significant difference of PFS and OS according to the KELIM score in those treated with chemotherapy alone. Moreover, high-KELIM score was a favorable factor for long-term BMT in only those treated with SCS (adjusted odd ratio, 15; 95% confidence interval, 1.225–18.363).
Conclusion/Implications High-KELIM had a predictive value for better prognosis and long-term BMT in patients with first platinum-sensitive ovarian cancer who received paclitaxel-carboplatin-bevacizumab followed by BMT after SCS.
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