Purpose: This trial was undertaken (1) to determine the feasibility of enrolling asymptomatic ovarian cancer patients with CA-125 elevation in a trial with the protein kinase C iota (PKCι) inhibitor auranofin and (2) to understand patients' perceptions of CA-125 monitoring. Methods: Asymptomatic ovarian cancer patients with CA-125 elevation received 3 mg auranofin orally twice per day and were evaluated. The patients participated in interviews about CA-125 monitoring. Results: Ten patients were enrolled in slightly over 6 months, exceeding our anticipated accrual rate. Four manifested stable CA-125 levels for 1 month or longer. The median progression-free survival was 2.8 months (95% CI: 1.3-3.8); auranofin was well tolerated. One patient had baseline and monthly CA-125 levels of 5,570, 6,085, 3,511, and 2,230 U/ml, respectively, stopped auranofin because of radiographic progression at 3 months, and manifested an increase in CA-125 to 7,168 U/ml approximately 3 months later. Patient interviews revealed (1) the important role of CA-125 in cancer monitoring, (2) ardent advocacy of CA-125 testing, and (3) an evolution toward CA-125 assuming a life of its own. Conclusions: This study showed the feasibility of enrolling asymptomatic ovarian cancer patients with CA-125 elevation in a trial with auranofin. One patient had a decline in CA-125, suggesting that PKCι inhibition merits further study in ovarian cancer. © 2014 S. Karger AG, Basel

1.
Parker PJ, Justilien V, Riou P, Minch M, Fields AP: Atypical protein kinase Cι as a human oncogene and therapeutic target. Biochem Pharmacol 2014;88:1-11.
2.
Zhang L, Huang J, Yang N, et al: Integrative genomic analysis of protein kinase C family identified PKCι as a biomarker and potential oncogene in ovarian carcinoma. Cancer Res 2006;66:4627-4635.
3.
Wang Y, Jill KS, Fields AP: PKCι maintains a tumor-initiating cell phenotype that is required for ovarian tumorigenesis. Mol Cancer Res 2013;11:1624-1635.
4.
Mansfield AS, Fields AP, Jatoi A, Qi Y, Adjei AA, Erlichman C, Molina JR: Phase I dose escalation study of the PKCι inhibitor aurothiomalate for advanced non-small cell lung cancer, ovarian cancer, and pancreatic cancer. Anticancer Drugs 2013;24:1079-1083.
5.
Syrios J, Banerjee S, Kaye SB: Advanced epithelial ovarian cancer: from standard chemotherapy to promising molecular pathway targets - where are we now? Anticancer Res 2014;34:2069-2077.
6.
Hurteau JA, Brady MF, Darcy KM, et al: Randomized phase III trial of tamoxifen versus thalidomide in women with biochemical-recurrent-only epithelial ovarian, fallopian tube or primary peritoneal carcinoma after a complete response to first-line platinum/taxane chemotherapy with an evaluation of serum vascular endothelial growth factor: a Gynecological Oncology Group Study. Gynecol Oncol 2010;119:444-450.
7.
Rustin GJ, van der Burg ME, Griffin CL, et al: Early versus delayed treatment of relapsed ovarian cancer (MRC OVO5/EORTC 55955): a randomized trial. Lancet 2010;376:1155-1163.
8.
Itokazu M, Matsunaga T, Oshita Y: Efficacy and safety of auranofin in patients with active early rheumatoid arthritis. Clin Ther 1995;17:60-73.
9.
Braun V, Clarke V: Using thematic analysis in psychology. Quant Res Psychol 2006;3:77-101.
10.
Patton MQ: Qualitative Research and Evaluation Methods, ed 3. Thousand Oaks, Sage, 2002, p 688.
11.
Harrison JD, Juraskova I, Anderson C, et al: Rising cancer antigen 125 level and the type and timing of treatment for recurrent ovarian cancer. Int J Gynecol Cancer 2009;19:1037-1046.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.