Exponential regression of CA 125 during salvage treatment of ovarian cancer with taxol

Exponential regression of CA 125 during salvage treatment of ovarian cancer with taxol

346 Citations from the literature/International Journal of Gynecology & Obstetrics 48 (1995) 343-351 founder, except for bloating, exceeded 6.5, wit...

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346

Citations from the literature/International Journal of Gynecology & Obstetrics 48 (1995) 343-351

founder, except for bloating, exceeded 6.5, with P s 10. All deaths occurred in the 28 patients with grade 2 or 3 tumors. Even in this smaller group, the hazard ratio for stage Ic-rupture was 6.8 (P = 0.09). Conclusion: Intraoperative rupture of malignant epithelial ovarian neoplasmsmay worsen the prognosis of patients with stage I ovarian cancer. Pretreatment plasma levels of tlbrinopeptide-A (FPA), Ddiier (DD), aad voo Wiilebrrad Faetor (vWF) in patients witb ovarian carciaoma Gadducci A.; Baicchi U.; Marrai R.; Del Bravo B.; Fosella P.V.; Facchini V. ITA GYNECOL ONCOL 1994 53/3 (352-356) The preoperative plasma levels of fibrinopeptide-A (FPA), D-dimer (DD), and von Willebrand Factor (vWF) were measuredin 125patients with ovarian massesundergoing laparotomy and in 88 healthy nonpregnant women as controls. FPA, DD, and vWF levels were significantly higher in the 58 patients with ovarian carcinoma than in the 67 patients with benign ovarian diseaseor controls. FPA and DD values were significantly higher in advanced (FIG0 stage III-IV) than in early ovarian carcinoma. Among patients with advanced disease,FPA and DD levels correlated with none of the common clinicopathological prognostic variables: conversely, vWF values were related to FIG0 stage(IV versus III, P < 0.02) and size of residual diseaseafter initial surgery ( > 2 cm versus2 cm, P < 0.05). in conclusion, increased fibrin production and degradation occur in patients with ovarian carcinoma. Coordinateexpressionof urinary-type piasmiaogenactivator and its receptor accompaniesmalignant transformation of tbe ovarian sorfaceepitbelium Young T.N.; Rodriguez G.C.; Moser T.L.; Bast R.C. Jr.; Pizza S.V.; Stack M.S. USA AM J OBSTET GYNECOL 1994 17015I (1285-1296) OBJECTIVE: Becauseelevated expression and cell surface association of urinary-type piasminogen activator have been linked to invasive potential in certain tumor types, we examined the expression of urinary-type plasminogen activator and urinary-type plasminogen activator receptor in ovarian epithelial carcinoma tissuesand cells as compared with normal ovarian epithelium. STUDY DESIGN: Monoclonal antibodies specific for urinary-type plasminogen activator and urinarytype plasminogen activator receptor were used for immunohistochemicai staining of tissues and cells to assessexpression of these antigens in frozen sections of normal and tumor tissue. Substrate zymography was used to detect plasminogen activator activity in ovarian carcinoma ascites and in conditioned media of cultured cells, whereas a Western blot assay was used to identify urinary-type plasminogen activator receptor in cultured cells. RESULTS: Normal ovarian epitheliurn expressedurinary-type plasminogen activator receptor (4/4 positive) but little or no urinary-type plasminogen activator (O/4positive), whereasepitheiial ovarian carcinomas frequently expressedurinary-type plasminogen activator (4/8 positive) in conjunction with urinary-type plasminogen activator receptor

(7/9 positive). High levels of urinary-type plasminogen activator were detected in 15 of 19 samples of ascites. DDV 13, OVCA 420, OVCA 429, OVCA 432, and OVCA 433 cell lines secretedurinary-type plasminogen activator in variable quantities, whereas normal ovarian epithelial cells did not secrete any detectable plasminogen activator. Urinary-type plasminogen activator receptor had similar levels of expression in all cancer cell lines and normal ovarian epithelium. CONCLUSION: Overexpressionof urinary-type plasminogen activator is associated with malignant transformation of the ovarian epithelium. Increasedcell surfaceproteolysis mediated by urinarytype plasminogen activator bound to ceil surface urinary-type plasminogen activator receptor may contribute to metastatic behavior in ovarian carcinoma. Exponential regressionof CA 125 during salvage treatment of ovarian cancer with taxoi Pearl M.L.; Yashar CM.; Johnston C.M.; Reynolds R.K.; Roberts J.A. USA GYNECOL ONCOL 1994 53/3 (339-343) The role of serum CA 125 in monitoring the response of epithelial ovarian cancer to treatment has been extensively investigated. The exponential regression curve [ ln(CA 125)= i + s (days after initiation of treatment)] has been reported to describethe rate of change of serum CA 125during treatment. In this model, the y-axis intercept (j) representsthe initial CA 125~secretingtumor burden, while the slope (s) is determined by the response to treatment. The exponential regression curve was calculated for 66 patients undergoing salvage chemotherapy with taxol. At a mean follow-up of 121 days, 50 (75%) patients had progressedand 35 (53%) had died. Stratification of the patients by stage, grade, or histology did not reveal any significant differences in the regression rate. When the patients were stratified by response,the mean regression rate was 0.0157 f 0.011 for patients with progressive disease (N = 19) vs. -0.0250 f 0.031 for those with stable disease(N = 25) and -0.0250 f 0.015 for those with a partial response(N = 22) (P < 0.0001). The regression rate did not correlate with progression-freeinterval or survival (P > 0.05). We conclude that changes in serum CA 125 levels follow an exponential regression curve in patients undergoing salvage chemotherapy with taxol for progressive or recurrent ovarian cancer. A positive regression rate may predict which patients will progress prior to the time progression becomesclinically evident. However, a negative rate fails to provide discriminatory utility in predicting progression-free interval or survival. Cispiatin, doxorobicia hydrochloride, and cyciopbospbamide followed by radiotberapy in bigb-risk endometriai carcinoma Smith M.R.; Peters W.A. III; Drescher C.W. USA AM J OBSTET GYNECOL 1994 170/6(1677-1682) OBJECTIVE: Our purpose was to assessthe effect of adjuvant platinum-based, multiagent chemotherapy followed by conventional radiotherapy on the recurrence-freeinterval, patterns of recurrence, and survival of women with completely