TY - JOUR
T1 - The Increasing Prognostic and Predictive Roles of the Tumor Primary Chemosensitivity Assessed by CA-125 Elimination Rate Constant K (KELIM) in Ovarian Cancer
T2 - A Narrative Review
AU - Lauby, Ambroise
AU - Colomban, Olivier
AU - Corbaux, Pauline
AU - Peron, Julien
AU - Van Wagensveld, Lilian
AU - Gertych, Witold
AU - Bakrin, Naoual
AU - Descargues, Pierre
AU - Lopez, Jonathan
AU - Kepenekian, Vahan
AU - Glehen, Olivier
AU - Philip, Charles Andre
AU - Devouassoux-Shisheboran, Mojgan
AU - Tod, Michel
AU - Freyer, Gilles
AU - You, Benoit
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/1
Y1 - 2022/1
N2 - Ovarian cancer is the gynecological cancer with the worst prognosis and the highest mortality rate because 75% of patients are diagnosed with advanced stage III-IV disease. About 50% of patients are now treated with neoadjuvant chemotherapy followed by interval debulking surgery (IDS). In that context, there is a need for accurate predictors of tumor primary chemosensitivity, as it may impact the feasibility of subsequent IDS. Across seven studies with more than 12,000 patients, including six large randomized clinical trials and a national cancer registry, along with a mega-analysis database with 5842 patients, the modeled CA-125 ELIMination rate constant K (KELIM), the calculation of which is based on the longitudinal kinetics during the first three cycles of platinum-based chemotherapy, was shown to be a reproducible indicator of tumor intrinsic chemosensitivity. Indeed, KELIM is strongly associated with the likelihood of complete IDS, subsequent platinum-free interval, progression-free survival, and overall survival, along with the efficacy of maintenance treatment with bevacizumab or veliparib. As a consequence, KELIM might be used to guide more subtly the medical and surgical treatments in a first-line setting. Moreover, it could be used to identify the patients with poorly chemosensitive disease, who will be the best candidates for innovative treatments meant to reverse the chemoresistance, such as cell cycle inhibitors or immunotherapy.
AB - Ovarian cancer is the gynecological cancer with the worst prognosis and the highest mortality rate because 75% of patients are diagnosed with advanced stage III-IV disease. About 50% of patients are now treated with neoadjuvant chemotherapy followed by interval debulking surgery (IDS). In that context, there is a need for accurate predictors of tumor primary chemosensitivity, as it may impact the feasibility of subsequent IDS. Across seven studies with more than 12,000 patients, including six large randomized clinical trials and a national cancer registry, along with a mega-analysis database with 5842 patients, the modeled CA-125 ELIMination rate constant K (KELIM), the calculation of which is based on the longitudinal kinetics during the first three cycles of platinum-based chemotherapy, was shown to be a reproducible indicator of tumor intrinsic chemosensitivity. Indeed, KELIM is strongly associated with the likelihood of complete IDS, subsequent platinum-free interval, progression-free survival, and overall survival, along with the efficacy of maintenance treatment with bevacizumab or veliparib. As a consequence, KELIM might be used to guide more subtly the medical and surgical treatments in a first-line setting. Moreover, it could be used to identify the patients with poorly chemosensitive disease, who will be the best candidates for innovative treatments meant to reverse the chemoresistance, such as cell cycle inhibitors or immunotherapy.
KW - ovarian cancer
KW - KELIM
KW - CA-125
KW - primary chemosensitivity
KW - treatment success
KW - RANDOMIZED CLINICAL-TRIAL
KW - PROGRESSION-FREE SURVIVAL
KW - PHASE-III TRIAL
KW - EPITHELIAL OVARIAN
KW - NEOADJUVANT CHEMOTHERAPY
KW - 1ST-LINE TREATMENT
KW - PRIMARY SURGERY
KW - FALLOPIAN-TUBE
KW - EXPLORATORY ANALYSIS
KW - CARBOPLATIN
U2 - 10.3390/cancers14010098
DO - 10.3390/cancers14010098
M3 - (Systematic) Review article
C2 - 35008262
SN - 2072-6694
VL - 14
JO - Cancers
JF - Cancers
IS - 1
M1 - 98
ER -