The role of biomarkers in the management of epithelial ovarian cancer

ABSTRACT

Introduction: Despite advances in surgery and chemotherapy for ovarian cancer, 70% of women still succumb to the disease. Biomarkers have contributed to the management of ovarian cancer by monitoring response to treatment, detecting recurrence, distinguishing benign from malignant pelvic masses and attempting to detect disease at an earlier stage.

Areas covered: This review focuses on recent advances in biomarkers and imaging for management of ovarian cancer with particular emphasis on early detection. Relevant literature has been reviewed and analyzed.

Expert commentary: Rising or persistent CA125 blood levels provide a highly specific biomarker for epithelial ovarian cancer, but not an optimally sensitive biomarker. Addition of HE4, CA 72.4, anti-TP53 autoantibodies and other biomarkers can increase sensitivity for detecting early stage or recurrent disease. Detecting disease recurrence will become more important as more effective therapy is developed. Early detection will require the development not only of biomarker panels, but also of more sensitive and specific imaging strategies. Effective biomarker strategies are already available for distinguishing benign from malignant pelvic masses, but their use in identifying and referring patients with probable ovarian cancer to gynecologic oncologists for cytoreductive operations must be encouraged.

KEYWORDS:

• Ovarian cancer
• biomarkers
• CA125
• HE4
• monitoring
• pelvic mass
• early detection
• cancer imaging

Declaration of interest

R.C. Bast receives royalties from Fujirebio Diagnostics Inc. for discovery of CA125. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by funds from the Early Detection Research Network (5 U01 CA200462-02) and the MD Anderson Ovarian SPORE (P50 CA83639), National Cancer Institute, Department of Health and Human Services; the Cancer Prevention Research Institute of Texas (RP160145); the National Institutes of Health (CA16672); Golfer’s Against Cancer, Mossy Foundation, Roberson Endowment, National Foundation for Cancer Research (88750); UT MD Anderson Women’s Moon Shot; UT MD Anderson Cancer Center Odyssey Program to W-L Yang, the Theodore N. Law Endowment for Scientific Achievement to W-L Yang; the Clyde H. Wright Memorial Fund to W-L Yang and Bristol-Myers Squibb Award in Clinical Research to W-L Yang and a generous donation from Stuart and Gaye Lynn Zarrow (88760).