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CA 125: fundamental and clinical aspects
R H Verheijen1, S von Mensdorff-Pouilly, G J van Kamp
1Department of Obstetrics and Gynaecology, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Seminars in Cancer Biology
|April 15, 1999
Summary
New monoclonal antibody (Mab) assays for cancer antigen 125 (CA 125) improve upon older tests by reducing interference. While CA 125 monitoring is valuable for ovarian cancer treatment response, its early detection sensitivity remains limited.
Area of Science:
- Oncology
- Immunology
- Biochemistry
Background:
- The CA 125 glycoprotein is a biomarker for ovarian cancer.
- Monoclonal antibodies (Mabs) targeting CA 125 have evolved, leading to new assay generations.
- Human anti-mouse antibody (HAMA) interference was a significant issue in earlier CA 125 assays.
Purpose of the Study:
- To evaluate new generation CA 125 assays compared to original assays.
- To discuss the clinical utility of CA 125 in ovarian cancer diagnosis, screening, and monitoring.
Main Methods:
- Development and classification of Mabs targeting distinct CA 125 epitope regions.
- Comparison of new generation assays with original assays using Receiver Operating Characteristic (ROC) curves.
- Analysis of CA 125 assay performance in early detection, high-risk populations, and treatment monitoring.
Main Results:
- New generation CA 125 assays combining Mabs to two distinct regions show improved performance over original assays.
- HAMA interference, a drawback of older tests, is largely resolved in current CA 125 assays.
- CA 125 assay sensitivity for early ovarian cancer detection remains low, limiting its use for general screening.
Conclusions:
- CA 125 assays are valuable for monitoring ovarian cancer treatment response and detecting inadequate responses to chemotherapy.
- While CA 125 has limited utility in early ovarian cancer detection and general screening, it can be used in high-risk populations.
- The role of CA 125 in detecting recurrences requires further investigation, with ongoing clinical trials.