Background: This multicenter retrospective study aimed to investigate the prognostic value of the CA-125 elimination rate constant K (KELIM) in EOC patients who received platinum-based chemotherapy followed by PARP inhibitors, in either upfront or interval treatment settings. Methods: Between July 2019 and November 2022, we identified stage III–IV EOC patients who underwent primary or interval cytoreductive surgery and received olaparib or niraparib. Individual KELIM values were assessed based on validated kinetics and classified into favorable and unfavorable cohorts. Results: In a study of 252 patients undergoing frontline maintenance therapy with olaparib or niraparib, favorable KELIM (≥1) scores were associated with a higher PFS benefit in the primary cytoreductive surgery (PCS) cohort (hazard ratio (HR) for disease progression or death 3.51, 95% confidence interval (CI); 1.37–8.97,p= 0.009). Additionally, within the interval cytoreductive surgery (ICS) cohort, a favorable KELIM score (≥1) significantly increased the likelihood of achieving complete resection following cytoreductive surgery, with 59.4% in the favorable KELIM group compared to 37.8% in those with unfavorable KELIM. Conclusions: A favorable KELIM score was associated with improved PFS in patients with advanced EOC undergoing PCS. Furthermore, in the ICS cohort, a favorable KELIM score increased the probability of complete cytoreduction.
背景：本项多中心回顾性研究旨在探讨CA-125清除率常数K（KELIM）在接受铂类化疗联合PARP抑制剂（奥拉帕利或尼拉帕利）维持治疗的上皮性卵巢癌（EOC）患者中的预后价值，治疗场景包括初始治疗与间歇性治疗。方法：在2019年7月至2022年11月期间，我们纳入了接受初次或间歇性肿瘤细胞减灭术并接受奥拉帕利或尼拉帕利治疗的III–IV期EOC患者。基于已验证的动力学模型计算个体KELIM值，并将其分为有利组与不利组。结果：在252例接受奥拉帕利或尼拉帕利一线维持治疗的患者中，初次肿瘤细胞减灭术（PCS）队列中，有利KELIM评分（≥1）与更长的无进展生存期（PFS）显著相关（疾病进展或死亡的风险比（HR）为3.51，95%置信区间（CI）1.37–8.97，p=0.009）。此外，在间歇性肿瘤细胞减灭术（ICS）队列中，有利KELIM评分（≥1）显著提高了肿瘤细胞减灭术后实现完全切除的可能性，其中有利KELIM组完全切除率为59.4%，而不利KELIM组仅为37.8%。结论：有利KELIM评分与接受PCS的晚期EOC患者PFS改善相关。在ICS队列中，有利KELIM评分可提高实现完全肿瘤细胞减灭的概率。
肿瘤(癌症)患者之家