CA-125 Early Dynamics to Predict Overall Survival in Women with Newly Diagnosed Advanced Ovarian Cancer Based on Meta-Analysis Data

Eleni Karamouza*, Rosalind M. Glasspool, Caroline Kelly, Liz Anne Lewsley, Karen Carty, Gunnar B. Kristensen, Josee Lyne Ethier, Tatsuo Kagimura, Nozomu Yanaihara, Sabrina Chiara Cecere, Benoit You, Ingrid A. Boere, Eric Pujade-Lauraine, Isabelle Ray-Coquard, Cécile Proust-Lima, Xavier Paoletti

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)
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(1) Background: Cancer antigen 125 (CA-125) is a protein produced by ovarian cancer cells that is used for patients’ monitoring. However, the best ways to analyze its decline and prognostic role are poorly quantified. (2) Methods: We leveraged individual patient data from the Gynecologic Cancer Intergroup (GCIG) meta-analysis (N = 5573) to compare different approaches summarizing the early trajectory of CA-125 before the prediction time (called the landmark time) at 3 or 6 months after treatment initiation in order to predict overall survival. These summaries included observed and estimated measures obtained by a linear mixed model (LMM). Their performances were evaluated by 10-fold cross-validation with the Brier score and the area under the ROC (AUC). (3) Results: The estimated value and the last observed value at 3 months were the best measures used to predict overall survival, with an AUC of 0.75 CI 95% [0.70; 0.80] at 24 and 36 months and 0.74 [0.69; 0.80] and 0.75 [0.69; 0.80] at 48 months, respectively, considering that CA-125 over 6 months did not improve the AUC, with 0.74 [0.68; 0.78] at 24 months and 0.71 [0.65; 0.76] at 36 and 48 months. (4) Conclusions: A 3-month surveillance provided reliable individual information on overall survival until 48 months for patients receiving first-line chemotherapy.

Original languageEnglish
Article number1823
Issue number6
Publication statusPublished - 17 Mar 2023

Bibliographical note

Funding Information:
This study was partly supported by grant PHRC-K 2017 ‘PHRC-K 17–187’ from the Programme Hospitalier de Recherche Clinique en Cancérologie, funded by the French Ministry of Health and the French Ligue Against Cancer.

Publisher Copyright:
© 2023 by the authors.


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