Monitoring performance of progression assessment criteria for cancer antigen 125 among patients with ovarian cancer compared by computer simulation

Background: Cancer antigen 125 (CA125) is used to monitor tumor burden among patients with advanced serous epithelial ovarian cancer. The purpose is to compare the monitoring performance of seven previously proposed criteria. Materials & methods: The CA125 assessment criteria were applied to simulated datasets. We investigated the ability to provide information on CA125 increments as well as their robustness against false positive signals. Results: For baseline concentrations above cut-off, the best performing criterion was based on a confirmed increment 2.5-times the nadir concentration. For baseline concentrations below cut-off, the best performing criterion was based on a confirmed increment from cut-off to >two-times cut-off. Discussion: Computer simulation models may be useful for a preclinical validation of criteria to be investigated in clinical trials.