Correlating the KELIM (CA125 elimination rate constant K) score and the chemo-response score as predictors of chemosensitivity in patients with advanced ovarian carcinoma

• Published in: Gynecologic oncology Vol. 187; pp. 92 - 97
• Main Authors: Piedimonte, Sabrina, Murray, Ciara, Atenafu, Eshetu G., Rouzbahman, Marjan, Lheureux, Stephanie, May, Taymaa
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2024
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; CA-125; CA-125 Antigen - blood; Carcinoma, Ovarian Epithelial - drug therapy; Carcinoma, Ovarian Epithelial - pathology; Carcinoma, Ovarian Epithelial - surgery; Chemotherapy, Adjuvant; Cohort Studies; CRS score; Cystadenocarcinoma, Serous - drug therapy; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - surgery; Cytoreduction Surgical Procedures; Female; Humans; KELIM score; Membrane Proteins; Middle Aged; Neoadjuvant chemotherapy; Neoadjuvant Therapy; Neoplasm Staging; Ovarian cancer; Ovarian Neoplasms - drug therapy; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Progression-Free Survival; Retrospective Studies; Survival; Neoadjuvant chemotherapy; CA-125; KELIM score; CRS score; Survival; Ovarian cancer
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2024.04.009

The objective of this study is to assess the correlation between the pre-operative CA125 Elimination rate constant K(KELIM) score and the intraoperative chemo-response score (CRS) in patients with advanced high grade serous ovarian cancer(HGSC) treated with neoadjuvant chemotherapy(NACT). This is a retrospective cohort study of patients with Stage III-IV HGSC treated with NACT from March 2010 to December 2019 at Princess Margaret Cancer Center, Toronto, Canada. KELIM scores were calculated based on the tool devised by You et al. available online. CRS was assessed using an established 3-tier scoring system. An association analysis was performed to determine if the KELIM score assessed during NACT can predict CRS score at the time of interval cytoreductive surgery(ICS). 172 patients were included in this analysis. Patients with CRS 1–2 had a lower median Platinum Free Interval(PFI) (9.24 vs 13.64 months, p = 0.005), lower median progression free survival(PFS) (14.99 vs 20.29 months, p = 0.003) and lower 5-year overall survival(OS) (63.8% vs 69.7%, p = 0.54) compared to patients with CRS3. Among patients with CRS 1–2(n = 115), 68.7% had KELIM <1, while 56.2% of patients with CRS3 had KELIM ≥1(56.2%), p = 0.0017, suggesting a correlation between the KELIM and CRS scores. Furthermore, patients with KELIM ≥1 and CRS3 had significantly higher PFS compared to other groups(median PFS 28.27 months vs 17.66 months for KELIM ≥1/CRS 1/2; 17.13 months for KELIM <1/CRS 3; and 14.53 months for KELIM <1/CRS 1–2, p = 0.003). The biochemical KELIM score correlated with the surgical pathologic CRS score and may predict pathological response to chemotherapy. This information can be utilized to tailor and personalize treatment in patients with advanced ovarian malignancy. •The KELIM score is predictive of chemotherapy response in patients with advanced ovarian cancer who are treated with NACT.•The KELIM score correlates with the pathologic CRS score.•The combination of the KELIM and CRS scores can be used to personalize treatment for patients with advanced ovarian cancer.