Front-line chemo-immunotherapy for treating epithelial ovarian cancer: Part I CA125 and anti-CA125

Taiwan J Obstet Gynecol. 2023 Nov;62(6):802-808. doi: 10.1016/j.tjog.2023.09.017.

Abstract

The current standard therapy of epithelial ovarian cancer (EOC) is the combination of surgery (primary cytoreductive surgery or interval cytoreductive surgery) and platinum-based chemotherapy (mainly using paclitaxel and carboplatin either by neoadjuvant chemotherapy and/or by postoperative adjuvant chemotherapy) with/without adding targeted therapy (mainly using anti-angiogenesis agent- bevacizumab). After front-line chemotherapy, the advanced-stage EOC can be successfully controlled and three-quarters of patients can achieve a complete clinical remission. Unfortunately, nearly all patients will recur and progression-free survival (PFS) of these patients is seldom more than 3 years with a dismal median PFS of 12-18 months. With each recurrence, patients finally develop resistance to standard chemotherapy regimen, contributing to fewer than half of women who survive for more than 5 years after diagnosis with a median overall survival (OS) of 40.7 months. Due to the lower PFS and OS, particularly for those advanced-stage patients, novel therapeutic options during the front-line therapy are desperately needed to decrease the occurrence of recurrence, and the majority of them are still under investigation. It is well-known that overexpression of CA125 has been associated with attenuated cellular apoptosis, platinum chemotherapy resistance, tumor proliferation and disease progression, suggesting that anti-CA125 may play a role in the management of patients with EOC. The current review is a Part I which will focus on development of anti-CA125 monoclonal antibody, hoping that alternation of the front-line therapy by chemo-immunotherapy will be beneficial for prolonged survival of patients with EOC.

Keywords: CA125; Epithelial ovarian cancer; Immuno-chemotherapy; Oregovomab.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carboplatin
  • Carcinoma, Ovarian Epithelial / drug therapy
  • Female
  • Humans
  • Immunotherapy
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / pathology
  • Paclitaxel / therapeutic use

Substances

  • Paclitaxel
  • Carboplatin