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Study Questions CA-125 for Ovarian Cancer Relapse

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A large, multicenter, randomized trial presented at the American Society of Clinical Oncology's annual meeting suggests that the current practice of monitoring cancer antigen 125 serum levels to predict women most at risk of relapse of ovarian cancer may be unnecessary.

The study, led by researchers at the UK's Mount Vernon Cancer Centre and the Netherlands' Erasmus MC University Medical Center, found no evidence that CA-125 monitoring made a difference in the overall survival of ovarian cancer patients who were immediately treated with chemotherapy based on CA-125 levels and those whose treatment was delayed until symptoms of recurrence showed.

"There is no survival benefit from early treatment based on a raised serum marker level alone, and therefore no value in the routine measurement of [CA-125] in the follow-up of ovarian cancer patients," the authors conclude in the abstract. In the study, researchers registered 1,442 women with a median age of 61 years whose ovarian cancer had gone into complete remission after receiving first-line, platinum-based chemotherapy.

In a discussion of this abstract at the meeting, Beth Karlan, chair of gynecologic oncology at Cedars-Sinai Medical Center and editor-in-chief of Gynecologic Oncology, lauded the trial results for potentially effecting changes to the standard of care in the treatment of ovarian cancer.

While oncologists should not entirely stop monitoring CA-125 in their early detection and treatment strategies for ovarian cancer patients, Karlan noted that the study results do suggest more limited monitoring of CA-125 in women with asymptomatic ovarian cancer.

Given the rising cost of healthcare, Karlan expressed that the study's findings could help oncologists avoid unnecessary CA-125 monitoring. Furthermore, she urged the "strategic use" of funding under the American Recovery and Reinvestment Act to continue discoveries in personalized therapies and advance early detection strategies in cancer treatment.

— Turna Ray


PGx & Molecular Dx Notes

The US Food and Drug Administration and the International Serious Adverse Event Consortium uncovered genetic associations between drug-induced liver injury and the antibiotic flucloxacillin. Some people who receive flucloxacillin — a drug widely used in Europe and Australia, but not approved in the US — have variations in the HLA-B and HCP-5 genes, placing them at greater risk for drug-induced liver injury, according to FDA.

Pfizer reported that its investigational drug developed to selectively attack certain genetic features of non-small cell lung cancer cells was able to stop or shrink tumor growth in a majority of patients enrolled in an early study. The drug, PF-02341066, is a dual inhibitor of mesenchymal epithelial transition growth factor and anaplastic lymphoma kinase translocation genes.


Datapoint

97 percent
of patients with eye cancer said they'd want genetic testing on their risk of metastasis even if it's not medically actionable


Funded Grants

$266,198/FY 2009
Statistical Methods for Cancer Biomarkers
Grantee: Jeremy Taylor, University of Michigan
Began: Jan. 1, 2009; Ends: Dec. 31, 2011

This National Cancer Institute grant will allow Taylor and his team to develop statistical approaches for making sense of single biomarkers or panels of biomarkers for cancer, such as algorithms for combining multiple biomarkers into a meaningful, predictive result and also using candidate biomarkers as "surrogate endpoints in randomized trials," the abstract says.

$398,053/FY 2009
Genetic variation and biomarkers in children with acute lung injury
Grantees: Heidi Flori and Michael Quasney, Medical College of Wisconsin
Began: May 1, 2009; Ends: Apr. 30, 2013

This funding from NHLBI will go toward studying "genetic variations in specific candidate genes and plasma biomarkers" in children who have acute lung injury or acute respiratory distress syndrome compared to children who don't have those conditions, according to the abstract. The study will include some 2,800 children.

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