Dr. Karlan said the findings will have a major impact on the cost of health care by decreasing the use of resources not shown to improve overall survival and quality of life. There will be less frequent assays, fewer follow-up tests, and improved quality of life.
It will take some time for patients to feel comfortable with this change in approach, she acknowledged, but the message to not worry about the next CA125 value should be a positive one for them. “So many live from one CA125 measure to the next and any small bumps in their levels can cause them great anxiety and distress.”
Dr. Karlan commented that the study, although very well done, also has some weaknesses. There was a lack of prescribed secondary- or tertiary-line chemotherapy, and the type of surgery was not considered. New drugs have come along. Platinum resistance and sensitivity were not factored into the analysis.
The study also points out the therapeutic limitations in advanced ovarian cancer, “a choice of whittling away at small disease or carving out large disease.” The findings should renew efforts to detect this disease at its earliest, and potentially curable, stage, she said.
The investigators had no relevant conflicts of interest in regard to this study.
At 56.9 months of follow-up, women who underwent CA125 monitoring had 'absolutely no difference in survival.' DR. RUSTIN