THE VALUE OF CANCER ANTIGEN-125 (CA-125) DURING TREATMENT AND FOLLOW-UP OF PATIENTS WITH OVARIAN-CANCER

Although the nature of the cancer antigen 125 leaves many questions un answered, the use of serum measurements as a means to assess the respo nse to surgery and chemotherapy in ovarian cancer is now well document ed. Good prognostic significance is attributed to a rapid decline in c ancer antigen 125 levels after chemotherapy in patients with advanced ovarian cancer. Pre-operative serum cancer antigen 125 levels may succ essfully discriminate benign from malignant adnexal masses in postmeno pausal women, but in women in their reproductive years the specificity is low. In stage I ovarian cancer patients, high preoperative cancer antigen 125 levels are reported to lead to a sixfold increase in the r isk of dying from the disease. Low expectations on the specificity and outcome of cancer antigen 125-based screening of asymptomatic women a re contradicted by the first results of screening programmes for postm enopausal women. Large, randomized, controlled studies will assess if survival can be improved by early detection of ovarian cancer. Experim ental immunotherapy by activation of the idiotypic network directed ag ainst cancer antigen 125 may offer new possibilities to prolong surviv al in advanced ovarian cancer.