The value of tumor marker-based RECIST criteria in efficacy evaluation for advanced ovarian cancer

doi:10.11958/20252869

Abstract

Abstract:

Objective To investigate the utility of tumor marker-based the response evaluation criteria in solid tumors ( RECIST) RecistTM in assessing chemotherapy response in advanced ovarian cancer. Methods A total of 90 patients of treatment-naïve FIGO stage III-IV ovarian cancer (2013-2023) with baseline tumor markers >3× ULN were retrospectively analyzed. All patients were received ≥2 cycles of platinum/taxane chemotherapy. Efficacy, progression-free survival (PFS) and overall survival (OS) were evaluated using RECIST and RecistTM. Cox regression analysis was conducted to analyze the influencing factors of disease progression and death in patients with ovarian cancer. Results The consistency of therapeutic effect evaluation was poor between RecistTM and RECIST (Kappa = 0.105，P<0.01). Under the RecistTM criteria, significant differences were observed in median tumor marker-related PFS（tmPFS）or OS between the tumor marker-related complete response (tmCR), tumor marker-related partial response (tmPR) and tumor marker-related stable disease + tumor marker-related progression disease (tmSD+tmPD) groups (PFS: 14 vs. 9 vs. 2.0 months; OS: 61 vs. 31 vs. 8 months; all P<0.01). In contrast, no significant differences were observed in either median PFS or OS between different response groups according to RECIST (all P>0.05). RecistTM demonstrated superior predictive performance for both progression (1-/3-year AUC: 0.707 vs. 0.540; 0.722 vs. 0.589, all P<0.05) and mortality risk (2-/3-/5-year AUC: 0.724 vs. 0.551; 0.702 vs. 0.522; 0.718 vs. 0.535, all P<0.05). Univariate and multivariable analysis indicated that the RecistTM criterion was an independent predictor of OS (P<0.01). Conclusion RecistTM shows superior predictive performance compared to RECIST in predicting disease progression and survival outcomes in advanced ovarian cancer.

Key words: ovarian neoplasms, progression-free survival, response evaluation criteria in solid tumors, RecistTM, survival analysis

CLC Number:

R737.31

Figures/Tables 9

References 20

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疗效	主要标志物	次要标志物	基线正常的标志物	其他需要符合的条件
tmCR	降至正常	降至正常	正常	全部满足上述条件，至少维持3周以上
tmPR	下降≥30%	下降，或上升≤20%	≤1.5倍临界值	全部满足上述条件，至少维持3周以上
tmSD	既不满足tmPR和tmCR，亦不满足tmPD
tmPD	上升≥30%	上升≥50%	≥2倍临界值	满足任一条件，至少维持3周以上

疗效	主要标志物	次要标志物	基线正常的标志物	其他需要符合的条件
tmCR	降至正常	降至正常	正常	全部满足上述条件，至少维持3周以上
tmPR	下降≥30%	下降，或上升≤20%	≤1.5倍临界值	全部满足上述条件，至少维持3周以上
tmSD	既不满足tmPR和tmCR，亦不满足tmPD
tmPD	上升≥30%	上升≥50%	≥2倍临界值	满足任一条件，至少维持3周以上

指标	β	SE	Wald χ²	P	HR	HR 95%CI
年龄	0.022	0.016	1.797	0.180	1.022	0.990~1.055
一线化疗周期数	-0.498	0.282	3.130	0.077	0.608	0.350~1.055
FIGO分期	0.212	0.283	0.559	0.455	1.236	0.709~2.153
IDS	-0.937	0.301	9.693	0.002	0.392	0.217~0.707
RECIST	0.130	0.308	0.178	0.673	1.139	0.623~2.081
RecistTM	1.074	0.306	12.282	<0.001	2.927	1.605~5.336

指标	β	SE	Wald χ²	P	HR	HR 95%CI
年龄	0.022	0.016	1.797	0.180	1.022	0.990~1.055
一线化疗周期数	-0.498	0.282	3.130	0.077	0.608	0.350~1.055
FIGO分期	0.212	0.283	0.559	0.455	1.236	0.709~2.153
IDS	-0.937	0.301	9.693	0.002	0.392	0.217~0.707
RECIST	0.130	0.308	0.178	0.673	1.139	0.623~2.081
RecistTM	1.074	0.306	12.282	<0.001	2.927	1.605~5.336

指标	β	SE	Wald χ²	P	HR	HR 95%CI
年龄	-0.017	0.019	0.814	0.367	0.983	0.947~1.020
一线化疗周期数	-0.208	0.323	0.415	0.519	0.812	0.432~1.529
FIGO分期	0.006	0.313	0.000	0.985	1.006	0.545~1.856
IDS	-0.706	0.385	3.355	0.067	0.494	0.232~1.051
RECIST	-0.012	0.336	0.001	0.971	0.988	0.511~1.910
RecistTM	0.916	0.343	7.127	0.008	2.499	1.276~4.896