Modeled CA-125 kinetics during neoadjuvant chemotherapy for predicting the likelihood of optimal interval debulking surgery in ovarian cancer patients: Data from CHIVA trial (a GINECO study).

Authors

null

Patrick Robelin

Hospices Civils de Lyon, Pierre-Bénite, France

Patrick Robelin , Michel Tod , Olivier Colomban , Christophe Louvet , Jean-Pierre Lotz , Sophie Abadie Lacourtoisie , Michel Fabbro , Christophe Desauw , Nathalie Bonichon , Jean Emmanuel Kurtz , Philippe Follana , Marianne Leheurteur , Francesco Del Piano , Carol René Alliot , Gaetan De Rauglaudre , Isabelle Laure Ray-Coquard , Pierre Combe , Annick Chevalier , Florence Joly , Benoit You

Organizations

Hospices Civils de Lyon, Pierre-Bénite, France, Université de Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon-Sud, Lyon, France, Laboratoire EMR3738 Ciblage Thérapeutique en Oncologie, Oullins, France, Institut Mutualiste Montsouris, Paris, France, Medical Oncology Department, Hospital Tenon (AP-HP), Paris, France, ICO Paul Papin, Angers, France, ICM Val d'Aurelle, Montpellier, France, Centre Hospitalier Universitaire, Lille, France, Tivoli Clinique, Bordeaux, France, Hôpitaux Universitaires de Strasbourg, Strasbourg, France, GINECO and Department of Medical Oncology, Centre Antoine-Lacassagne, Nice, France, Centre Henri Becquerel, Rouen, France, GINECO-Hôpitaux du Léman, Thonon Les Bains, France, Centre Hospitalier Alpes Leman, Contamine-Sur-Arve, France, GINECO and Institut Sainte-Catherine, Avignon, France, Centre Léon-Bérard, Lyon, France, Hôpital Européen Georges Pompidou (HEGP), Assistance Publique Hôpitaux de Paris (AP-HP), Paris, France, Centre Oscar Lambret, Lille, France, GINECO and Regional Centre Control Against Cancer Francois Baclesse, Caen, France, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, EMR UCBL/HCL 3738, Lyon, GINECO & GINEGEPS, France, Lyon, France

Research Funding

Other
Pharmaceutical/Biotech Company

Background: A pre-operative predictive biomarker of CC0 interval debulking surgery (IDS) likelihood would be helpful. The modeled CA125 elimination rate constant KELIM predicts OS in 1st line setting (You et al. Clin Cancer Res 2019). The predictive/prognostic values of KELIM regarding CC scores at IDS, and survivals, during neo-adjuvant chemotherapy were assessed. Methods: The data of the CHIVA randomized phase II trial, comparing carboplatin-paclitaxel +/- nintedanib before IDS (NCT01583322), were used. A semi-mechanistic model was built to describe CA125 longitudinal kinetics during the first 100 treatment days. The relationships between KELIM and IDS CC scores, PFS & OS, were assessed with other major prognostic factors (grade, histology, GCIG CA125 response, FIGO stage, and arm) using multivariate logistic regression (logit), C-index & survival tests. Results: The longitudinal kinetics of 529 CA125 values, assessed every 3 weeks during neo-adj chemotherapy, were modeled in 133 patients (out of 188). KELIM (as a continuous covariate) was the only significant predictive factor of CC0 IDS likelihood using multivariate analyses (OR = 12.37, 95% CI [4.32-39.67]). CC0 IDS probability can be estimated with patient KELIM: ≥ 90 % if standardized KELIM ≥ 0.12. Non-parametric survival models confirmed the independent predictive values of KELIM categorized by terciles regarding PFS & OS (Table). The parametric model linking KELIM (as a continuous covariate) with OS allows to predict the patient survivals (months) based on their estimated KELIM (HR = 0.20, [0.10-0.39]). Conclusions: The prognostic & predictive values of the modeled CA125 KELIM are also confirmed regarding CC0 IDS likelihood, PFS and OS with neo-adjuvant chemotherapy. Patient KELIM is calculable online, based on observed CA125 values, on http://www.biomarker-kinetics.org/. Clinical trial information: 2011-006288-23.

KELIM tercilesPFS monthsPFS HR, [95% CI]OS monthsOS HR, [95% CI]
Lower [min,0.037]8.8Ref22.1Ref
Intermediate (0.037,0.0684]11.20.46 [0.29-0.74]44.60.38 [0.22-0.68]
Upper (0.0684,max]19.10.30 [0.19-0.49]48.70.31 [0.18-0.55]

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Clinical Trial Registration Number

2011-006288-23

Citation

J Clin Oncol 37, 2019 (suppl; abstr 5546)

DOI

10.1200/JCO.2019.37.15_suppl.5546

Abstract #

5546

Poster Bd #

369

Abstract Disclosures