Epithelial Ovarian Cancer
Conditions
Brief summary
In this study, we hypothesize that calculating the ROMA score (CA125 + HE4 blood marker assay) will enable faster, more targeted diagnosis and management of epithelial ovarian cancer recurrence than the CA125 marker assay alone. This early identification of recurrence would then improve patients' quality of life, since it would increase the chances of benefiting from less invasive and less morbid surgery. It would also reduce the cost of patient management following disease progression. If our hypothesis is confirmed, the results of this study will enable us to update the recommendations for post-treatment follow-up of patients in remission from epithelial ovarian cancer, as well as reimbursing the HE4 marker assay (and thus the calculation of the ROMA score).
Interventions
DIAGNOSTIC_TESTROMA score evaluation
Every 4 months, for 3 years, patients in the experimental group will done a biological examination based on assessment of the ROMA score (CA125+HE4 assay).
Sponsors
University Hospital, Tours
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Women aged 18 or over and less than 85 years old * With proven FIGO stage I to IV epithelial ovarian cancer (ovary/tumor/peritoneum) * Women in remission after first-line chemotherapy, with a normal CA125 less than 4 months old at study entry (end of first-line chemotherapy). * Woman having completed chemotherapy at least 6 months previously * Written informed consent * French social security
Exclusion criteria
* Any physical or psychiatric condition that may interfere with the patient's cooperation in data collection * Patient with normal CA125 at initial diagnosis of epithelial ovarian cancer * Patient under guardianship * Patient deprived of liberty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incremental Cost-Utility Ratio (ICUR) expressed as the cost per QALY gained at 36 months of using the ROMA score compared to usual follow-up with the CA-125 test, from the collective perspective. | 36 months | QALYs (Quality-Adjusted Life Years) will be estimated from patient responses to the EQ-5D-5L instrument (EuroQol group - 5 Dimensions - 5 levels). The cost evaluation will identify, measure and value all the resources consumed in the production of overall care: hospital and outpatient care, transport, informal care, and social aid services. All consumed resources will be estimated from the collective perspective. QALY and cost data will be used to estimate this within-trial ICUR. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incremental Cost-Effectiveness Ratio (ICER) expressed as the cost per life-year gained at 36 months of using the ROMA score compared to usual follow-up with the CA-125 test, from the collective perspective. | 36 months | Cost and survival data will be used to estimate the within-trial ICER. |
| Incremental Cost-Utility Ratio (ICUR) expressed as the cost per QAPFY gained at 36 months of using the ROMA score compared to usual follow-up with the CA-125 test, from the collective perspective. | 36 months | QAPFY (Quality-Adjusted Progression-Free Years) will be estimated using the progression-free survival data and patient responses to the EQ-5D-5L instrument. Cost and QAPFY data will be used to estimate this within-trial ICUR. |
| Financial impact per year and over a 5-year period of spreading the use of the ROMA score in the routine follow-up of patients for the diagnosis of the first recurrence of epithelial ovarian cancer. | per year and over a 5-year period | The financial impact will be estimated from the French Health Insurance, using a budget impact model. |
| Characteristics of recurrence between the two groups (i.e. time to recurrence, location and operability) | 36 months | Proportion of patients with a first operable recurrence, median interval between randomization and diagnosis of recurrence by imaging or biopsy |
| Characteristics of treatments for first recurrence (including surgery) | 36 months | Proportion of patients with complete surgery without macroscopic residue, without reoperation, proportion of other therapies: chemotherapy/hormone therapy/other therapies |
| Quality of life of women | 36 months | Quality of life assessed by the EORTC QLQ-C30 and EORTC QLQ-OV28 (European Organization for Research and Treatment in Cancer Quality Life Questionnaire) every 4 months for 3 years |
| Evolution of CA125, HE4 and ROMA score after management of the first recurrence | 36 months | Description of the evolution of CA125, HE4 and ROMA score after management of the first recurrence |
| Estimation and validation of a mapping function from the specific EORTC QLQ-C30 and EORTC QLQ-OV28 questionnaires to the generic EQ-5D5L questionnaire. | 36 months | Deriving the EQ5D-5L score from responses to the EORTC QLQ-C30 and QLQ-OV28 questionnaires in women undergoing post-treatment remission follow-up of epithelial ovarian cancer. |
Outcome results
None listed