CA-125 monitoring during chemotherapy for ovarian cancer.

Serum CA-125 was determined in 60 patients with variously extended ovarian cancer and monitored during and after chemotherapy. The study indicates that: 1) prechemotherapy CA-125 shows the presence of an active disease with an accuracy greater than 85%. The antigen is elevated in 97% of patients with greater than 2 cm disease, but sensitivity is low (67%) in patients with minimal residual disease (less than 2 cm); 2) changes in CA-125 correspond well with the response to chemotherapy. CA-125 becomes negative in every patient having clinical CR and increases in every patient with progressive disease. These changes can indicate the type of response some months ahead of time; 3) CA-125 indicates in advance the recurrence of the disease after an objective remission: 4) In the conditions studied CA-125 basal levels do not seem to have prognostic value as regarding either response or survival.

Cisplatinum plus epirubicin alternated with cyclophosphamide plus 5-fluorouracil in ovarian cancer.

Fifty-two patients with ovarian cancer (post surgical residual tumor) were treated with the combination of platinum + epirubicin (PE) (P 50mg/m2, E 60 mg/m2) alternated with cyclophosphamide + 5-fluorouracil (CF) (C 800 mg/m2, F 600 mg/m2). The treatment was repeated every 28 days for a maximum of 10 cycles. Forty-three patients were evaluable for response. Complete remission (CR) was achieved in 13 (30%) patients (evaluated by second-look), while partial remission (PR) was achieved in 6 (14%) patients for a mean duration of 27 and 14 months, respectively. Eleven out of 13 patients with CR and 5 out of the nonevaluable patients are alive and do not show signs of disease after a mean follow-up of 29 + months (range 19-36). The main factors that conditioned complete remission were the tumor residue and performance status of the patient.

Four-year analysis of platinum and anthracycline combination for ovarian cancer.

Eighty-nine patients with advanced ovarian cancer have been treated with a combination of cis-platinum (50 mg/m2) + an anthracycline (adriamycin 50 mg/m2 in 26 patients, or epirubicin 60 mg/m2 in 63 patients). The treatment was repeated every 28 days for a maximum of 12 cycles. Seventy-nine were evaluable for response. CR was achieved in 19 (24%) patients (2 clinical and 17 after a second-look evaluation) and a PR in 31 (39%) for an estimated median duration of 43 and 10 months, respectively. Nine patients who achieved CR and 2 out of 10 non-evaluable patients were alive without any evidence of disease after a median follow-up of 36 months (range 29-53). The treatment was generally well tolerated. The multivariate actuarial 4-year analysis by Cox's proportional hazards model shows that residual tumor and performance status have an independent prognostic value on survival. The combination of CP + an anthracycline (and in particular epirubicin) is an effective and generally well tolerated treatment for ovarian cancer. Only patients with initial minimal residual disease and achieving CR are candidates for long-term survival.