Abstract
BACKGROUND: The KELIM index, a dynamic biomarker derived from CA125 kinetics, has shown prognostic value in ovarian cancer. However, its predictive role under contemporary treatment paradigms incorporating bevacizumab and PARP inhibitors remains underexplored. OBJECTIVE: To evaluate the predictive value of the KELIM index for progression-free survival (PFS) in ovarian cancer patients treated with current therapeutic modalities. METHODS: A total of 52 patients with ovarian cancer who underwent surgical treatment in the Affiliated Hospital of Jiaxing University from January 1, 2020 to September 30, 2023 were retrospectively analyzed. Clinicopathological data, treatment details (including bevacizumab/PARPi use), and serial CA125 values were collected. The KELIM index was calculated using the online biomarker kinetics tool (https://www.biomarker-kinetics.org/CA125). Cox regression and Kaplan-Meier analyses assessed prognostic factors. RESULTS: The mean age of the 52 patients was 55.17±13.57 years, and the mean body mass index (BMI) was 22.95±3.62kg/m(2). There were 35 cases (67.3%) in the KELIM index ≥1 group and 17 cases (32.7%) in the KELIM index < 1 group. Multivariate analysis identified KELIM index (HR=0.25, 95% CI 0.077-0.818, P<0.05) and treatment approach (direct surgery vs NACT+IDS) as independent PFS predictors. Patients with KELIM<1 had a median PFS of 38.3 months, while those with KELIM≥1 did not reach median PFS (P<0.05). CONCLUSION: The KELIM index is expected to be another high quality index for predicting OC under the current treatment model, potentially guiding personalized treatment intensification.