Stamp, Scrap, CURE!

 

June 4, 2009 (Washington DC): The Ovarian Cancer National Alliance expressed concern today that a study, released last week at the annual meeting of the American Society of Clinical Oncology in Orlando, Florida, asserts that early detection of recurrent disease using the CA125 test five months earlier does not make any difference in survival, given the inability of early treatment to affect the course of the disease. This finding challenges the idea that the standard use of CA125 as a regularly administered test to detect recurrence of ovarian cancer offers women the chance to monitor the disease and choose to be proactive in treating its recurrence. The data, presented by Dr. J.S. Rustin, suggests that ovarian cancer survivors who receive chemotherapy treatment based on the CA125 test did not live longer with treatment given before symptoms reappeared than women who waited to begin therapeutic chemotherapy once symptoms appeared. Such symptoms include bloating, frequency or urgency of urination, difficulty of eating or feeling full quickly and pelvic and abdominal pain appeared.

Rustin states, "For the first time, women can be reassured that there's no benefit to early detection of relapse from routine CA125 testing." Dr. Rustin is director of medical oncology at Mount Vernon Hospital in Middlesex, England, and the lead author of the study. However, this is far from reassuring to ovarian cancer survivors.

The Ovarian Cancer National Alliance noted that perhaps the greatest fear of women who have survived a diagnosis of ovarian cancer is that this insidious disease will recur, and often it does. Thus, of paramount importance to these women is the ability of a test like the CA125 to quickly and accurately detect a recurrence so treatment can be initiated. Though the study suggests that such treatment may not affect the ultimate outcome, the larger question becomes one of treatment options, rather than detection options.

Currently, CA125 and the CA125+HE4 are both FDA approved to monitor recurrence. Even in the absence of noticeable symptoms, a rising CA125 may lead to further tests such as an MRI, which will detect the disease, at which time therapies can be given. Additionally, other tools such as PET scans are used to detect cancer at the cellular level. 

CA125 was developed by Dr. Robert Bast, Vice President for Translational Research at The University of Texas M.D. Anderson Cancer Center in Houston.

Dr. Bast commented, "Dr. Ruston's presentation emphasizes the need to discuss with each patient whether or not to monitor CA125 after the completion of primary chemotherapy. It will, however, be critical that women continue to have that choice, as many women will want to know the status of their own disease and will want to have the additional five months to receive novel treatments that might be more effective against small volumes of recurrent cancer. "

According to the conclusion of Rustin's abstract, it states that "there is no survival benefit from early treatment on a raised serum marker level alone and therefore no value in the routine measurement of CA125 in the follow-up of ovarian cancer patients."

The data may be misinterpreted, as physicians who participated in the study were not required to use one therapeutic protocol, but made their own determination on which chemotherapy to use. Bast explains, "The majority of women did not receive optimal chemotherapy at the time of disease recurrence."

Karen Orloff Kaplan, CEO for the Ovarian Cancer National Alliance, states that "Women should not have to live with the fear of recurrence, test to test. Dr. Rustin's conclusion makes the point that we need better measurements for recurrence as well as initial diagnosis. Nevertheless, although CA125 may not be a completely accurate test for presence of ovarian cancer in many women, it has shown promise for others. Our hope is that these new findings will serve as a catalyst to the research community and those who fund their work, to redouble their efforts to find an early detection test, and more effective treatments, when survival rates are highest."

________________________________________
About the Ovarian Cancer National Alliance
Established in 1997, the Ovarian Cancer National Alliance is the foremost advocate for ovarian cancer in the United States. Until there's a cure for the disease, the Ovarian Cancer National Alliance, a 501(c)(3) organization, leads the national initiative to conquer ovarian cancer. We unite individuals and organizations at the local, state, and national levels to advance ovarian cancer research in the quest for early detection tests, improved health care practices, and development of live-saving treatment protocols.