Oncologists base prognosis, the predicted long-term outcome of an individual’s cancer, on the chances of recovery versus the chances of experiencing a recurrence or failure to respond to interventions. A clear understanding of prognosis can significantly influence treatment planning, lifestyle, and overall quality of life of a cancer patient. Thus, ongoing research to uncover, validate, and optimize the predictive accuracy of prognostic factors, modifiable or non-modifiable characteristics that help estimate prognosis, has significant value to areas of cancer treatment and care.
A meta-analysis recently published in the International Journal of Gynecological Cancer evaluated the value of different prognostic factors for epithelial ovarian cancer, an aggressive and deadly cancer occurring in the tissue lining women’s ovaries.
Epithelial ovarian cancer represents a highly fatal disease, with an estimated 19,680 new cases and 12,740 deaths in the United States in 2024. Diagnosis of ovarian cancer remains challenging, and as a result, most women with ovarian cancer have advanced-stage disease. Once advanced, ovarian cancer may spread into the peritoneum, the tissue lining the abdominal wall and pelvic cavity, making it difficult to identify small lesions and fully assess the condition.
These challenges have led to evaluating cancer antigen 125 (CA125), a marker detectable in blood and elevated in patients with ovarian cancer, to assess the progression or regression of ovarian cancer. CA125, present in around 90% of ovarian cancer cases, has thus become a prognostic marker for monitoring the disease.
Many studies have evaluated different readouts related to CA125 to predict treatment response. Studies have focused on various prognostic factors, including CA125’s the absolute value, half-life, nadir level (a measure indicating the lowest CA125 count found in the blood), and KELIM (a mathematically modeled kinetic measurement of CA125 clearance during chemotherapy). The meta-analysis evaluated the prognostic value of these factors based on how well they predicted survival in ovarian cancer patients.
The analysis evaluated studies published before February 2023 that reported survival outcomes related to a specific prognostic factor. The researchers identified 27 different studies encompassing 14,444 women with epithelial ovarian cancer.
The researchers reported that patients with favorable KELIM scores lived longer than those with less favorable scores. This trend appeared among both primary ovarian cancers and recurrent cases. The authors suggest their findings support the incorporation of KELIM scoring in ongoing assessments of progress during anticancer treatment. Adding KELIM readouts into models could help inform the design of future clinical trials and also guide treatment decisions for patients and clinicians.
Sources: CA, Int J Gynecol Cancer (Rutten), Int J Gynecol Cancer (Kim), Cancers, Gynocol Oncol
