Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer

Danka Sinikovic Zebic; Angelina Tjokrowidjaja; Katherine Elizabeth Francis; Michael Friedlander; Val Gebski; Alain Lortholary; Florence Joly; Annette Hasenburg; Mansoor Mirza; Ursula Denison; Sabrina Chiara Cecere; Annamaria Ferrero; Eric Pujade-Lauraine; Chee Khoon Lee

doi:10.1038/s41416-023-02528-z

Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer

Danka Sinikovic Zebic^*
, Angelina Tjokrowidjaja
, Katherine Elizabeth Francis
, Michael Friedlander
, Val Gebski
, Alain Lortholary
, Florence Joly
, Annette Hasenburg
, Mansoor Mirza
, Ursula Denison
, Sabrina Chiara Cecere
, Annamaria Ferrero
, Eric Pujade-Lauraine
, Chee Khoon Lee

^*Corresponding author for this work

Department of Oncology

8 Citations (Scopus)

Abstract

BACKGROUND: CA-125 alone is widely used to diagnose progressive disease (PD) in platinum-sensitive recurrent ovarian cancer (PSROC) on chemotherapy. However, there are increasing concerns regarding its accuracy. We assessed concordance between progression defined by CA-125 and RECIST using data from the CALYPSO trial.

METHODS: We computed concordance rates for PD by CA-125 and RECIST to determine the positive (PPV) and negative predictive values (NPV).

RESULTS: Of 769 (79%) evaluable participants, 387 had CA-125 PD, where only 276 had concordant RECIST PD (PPV 71%, 95% CI 67-76%). For 382 without CA-125 PD, 255 had RECIST PD but 127 did not (NPV 33%, 95% CI 29-38). There were significant differences in NPV according to baseline CA-125 (≤100 vs >100: 42% vs 25%, P < 0.001); non-measurable vs measurable disease (51% vs 26%, P < 0.001); and platinum-free-interval (>12 vs 6-12 months: 41% vs 14%, P < 0.001). We observed falling CA-125 levels in 78% of patients with RECIST PD and CA-125 non-PD.

CONCLUSION: Approximately 2 in 3 women with PSROC have RECIST PD but not CA-125 PD by GCIG criteria. Monitoring CA-125 levels alone is not reliable for detecting PD. Further research is required to investigate the survival impact of local therapy in radiological detected early asymptomatic PD.

Original language	English
Journal	British Journal of Cancer
Volume	130
Issue number	3
Pages (from-to)	425-433
Number of pages	9
ISSN	0007-0920
DOIs	https://doi.org/10.1038/s41416-023-02528-z
Publication status	Published - Feb 2024

Keywords

Carcinoma, Ovarian Epithelial
Female
Humans
Neonicotinoids
Neoplasm Recurrence, Local/drug therapy
Ovarian Neoplasms/diagnostic imaging
Response Evaluation Criteria in Solid Tumors
Thiazines

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10.1038/s41416-023-02528-z

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Zebic, D. S., Tjokrowidjaja, A., Francis, K. E., Friedlander, M., Gebski, V., Lortholary, A., Joly, F., Hasenburg, A., Mirza, M., Denison, U., Cecere, S. C., Ferrero, A., Pujade-Lauraine, E., & Lee, C. K. (2024). Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer. British Journal of Cancer, 130(3), 425-433. https://doi.org/10.1038/s41416-023-02528-z

Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer. / Zebic, Danka Sinikovic; Tjokrowidjaja, Angelina; Francis, Katherine Elizabeth et al.
In: British Journal of Cancer, Vol. 130, No. 3, 02.2024, p. 425-433.

Research output: Contribution to journal › Journal article › Research › peer-review

Zebic, DS, Tjokrowidjaja, A, Francis, KE, Friedlander, M, Gebski, V, Lortholary, A, Joly, F, Hasenburg, A, Mirza, M, Denison, U, Cecere, SC, Ferrero, A, Pujade-Lauraine, E & Lee, CK 2024, 'Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer', British Journal of Cancer, vol. 130, no. 3, pp. 425-433. https://doi.org/10.1038/s41416-023-02528-z

@article{ba9b68775294489b89243b45d32a62c7,

title = "Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer",

abstract = "BACKGROUND: CA-125 alone is widely used to diagnose progressive disease (PD) in platinum-sensitive recurrent ovarian cancer (PSROC) on chemotherapy. However, there are increasing concerns regarding its accuracy. We assessed concordance between progression defined by CA-125 and RECIST using data from the CALYPSO trial.METHODS: We computed concordance rates for PD by CA-125 and RECIST to determine the positive (PPV) and negative predictive values (NPV).RESULTS: Of 769 (79\%) evaluable participants, 387 had CA-125 PD, where only 276 had concordant RECIST PD (PPV 71\%, 95\% CI 67-76\%). For 382 without CA-125 PD, 255 had RECIST PD but 127 did not (NPV 33\%, 95\% CI 29-38). There were significant differences in NPV according to baseline CA-125 (≤100 vs >100: 42\% vs 25\%, P < 0.001); non-measurable vs measurable disease (51\% vs 26\%, P < 0.001); and platinum-free-interval (>12 vs 6-12 months: 41\% vs 14\%, P < 0.001). We observed falling CA-125 levels in 78\% of patients with RECIST PD and CA-125 non-PD.CONCLUSION: Approximately 2 in 3 women with PSROC have RECIST PD but not CA-125 PD by GCIG criteria. Monitoring CA-125 levels alone is not reliable for detecting PD. Further research is required to investigate the survival impact of local therapy in radiological detected early asymptomatic PD.",

keywords = "Carcinoma, Ovarian Epithelial, Female, Humans, Neonicotinoids, Neoplasm Recurrence, Local/drug therapy, Ovarian Neoplasms/diagnostic imaging, Response Evaluation Criteria in Solid Tumors, Thiazines",

author = "Zebic, \{Danka Sinikovic\} and Angelina Tjokrowidjaja and Francis, \{Katherine Elizabeth\} and Michael Friedlander and Val Gebski and Alain Lortholary and Florence Joly and Annette Hasenburg and Mansoor Mirza and Ursula Denison and Cecere, \{Sabrina Chiara\} and Annamaria Ferrero and Eric Pujade-Lauraine and Lee, \{Chee Khoon\}",

note = "{\textcopyright} 2023. Crown.",

year = "2024",

month = feb,

doi = "10.1038/s41416-023-02528-z",

language = "English",

volume = "130",

pages = "425--433",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Springer Nature",

number = "3",

}

TY - JOUR

T1 - Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer

AU - Zebic, Danka Sinikovic

AU - Tjokrowidjaja, Angelina

AU - Francis, Katherine Elizabeth

AU - Friedlander, Michael

AU - Gebski, Val

AU - Lortholary, Alain

AU - Joly, Florence

AU - Hasenburg, Annette

AU - Mirza, Mansoor

AU - Denison, Ursula

AU - Cecere, Sabrina Chiara

AU - Ferrero, Annamaria

AU - Pujade-Lauraine, Eric

AU - Lee, Chee Khoon

PY - 2024/2

Y1 - 2024/2

N2 - BACKGROUND: CA-125 alone is widely used to diagnose progressive disease (PD) in platinum-sensitive recurrent ovarian cancer (PSROC) on chemotherapy. However, there are increasing concerns regarding its accuracy. We assessed concordance between progression defined by CA-125 and RECIST using data from the CALYPSO trial.METHODS: We computed concordance rates for PD by CA-125 and RECIST to determine the positive (PPV) and negative predictive values (NPV).RESULTS: Of 769 (79%) evaluable participants, 387 had CA-125 PD, where only 276 had concordant RECIST PD (PPV 71%, 95% CI 67-76%). For 382 without CA-125 PD, 255 had RECIST PD but 127 did not (NPV 33%, 95% CI 29-38). There were significant differences in NPV according to baseline CA-125 (≤100 vs >100: 42% vs 25%, P < 0.001); non-measurable vs measurable disease (51% vs 26%, P < 0.001); and platinum-free-interval (>12 vs 6-12 months: 41% vs 14%, P < 0.001). We observed falling CA-125 levels in 78% of patients with RECIST PD and CA-125 non-PD.CONCLUSION: Approximately 2 in 3 women with PSROC have RECIST PD but not CA-125 PD by GCIG criteria. Monitoring CA-125 levels alone is not reliable for detecting PD. Further research is required to investigate the survival impact of local therapy in radiological detected early asymptomatic PD.

AB - BACKGROUND: CA-125 alone is widely used to diagnose progressive disease (PD) in platinum-sensitive recurrent ovarian cancer (PSROC) on chemotherapy. However, there are increasing concerns regarding its accuracy. We assessed concordance between progression defined by CA-125 and RECIST using data from the CALYPSO trial.METHODS: We computed concordance rates for PD by CA-125 and RECIST to determine the positive (PPV) and negative predictive values (NPV).RESULTS: Of 769 (79%) evaluable participants, 387 had CA-125 PD, where only 276 had concordant RECIST PD (PPV 71%, 95% CI 67-76%). For 382 without CA-125 PD, 255 had RECIST PD but 127 did not (NPV 33%, 95% CI 29-38). There were significant differences in NPV according to baseline CA-125 (≤100 vs >100: 42% vs 25%, P < 0.001); non-measurable vs measurable disease (51% vs 26%, P < 0.001); and platinum-free-interval (>12 vs 6-12 months: 41% vs 14%, P < 0.001). We observed falling CA-125 levels in 78% of patients with RECIST PD and CA-125 non-PD.CONCLUSION: Approximately 2 in 3 women with PSROC have RECIST PD but not CA-125 PD by GCIG criteria. Monitoring CA-125 levels alone is not reliable for detecting PD. Further research is required to investigate the survival impact of local therapy in radiological detected early asymptomatic PD.

KW - Carcinoma, Ovarian Epithelial

KW - Female

KW - Humans

KW - Neonicotinoids

KW - Neoplasm Recurrence, Local/drug therapy

KW - Ovarian Neoplasms/diagnostic imaging

KW - Response Evaluation Criteria in Solid Tumors

KW - Thiazines

UR - https://www.scopus.com/pages/publications/85179695438

U2 - 10.1038/s41416-023-02528-z

DO - 10.1038/s41416-023-02528-z

M3 - Journal article

C2 - 38097739

SN - 0007-0920

VL - 130

SP - 425

EP - 433

JO - British Journal of Cancer

JF - British Journal of Cancer

IS - 3

ER -

Discordance between GCIG CA-125 progression and RECIST progression in the CALYPSO trial of patients with platinum-sensitive recurrent ovarian cancer

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