Biomarkers and Strategies for Early Detection of Ovarian Cancer

Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%–30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two-stage strategies have proven more effective, where a s...

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Published inCancer epidemiology, biomarkers & prevention Vol. 29; no. 12; pp. 2504 - 2512
Main Authors Bast, Robert C., Lu, Zhen, Han, Chae Young, Lu, Karen H., Anderson, Karen S., Drescher, Charles W., Skates, Steven J.
Format Journal Article
LanguageEnglish
Published United States 01.12.2020
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ISSN1055-9965
1538-7755
1538-7755
DOI10.1158/1055-9965.EPI-20-1057

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Abstract Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%–30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two-stage strategies have proven more effective, where a significant rise above a woman's baseline CA125 prompts TVS and an abnormal sonogram prompts surgery. Two major screening trials have documented that this strategy has adequate specificity, but sensitivity for early-stage (I–II) disease must improve to have a greater impact on mortality. To improve the first stage, different panels of protein biomarkers have detected cases missed by CA125. Autoantibodies against TP53 have detected 20% of early-stage ovarian cancers 8 months before elevation of CA125 and 22 months before clinical diagnosis. Panels of autoantibodies and antigen–autoantibody complexes are being evaluated with the goal of detecting >90% of early-stage ovarian cancers, alone or in combination with CA125, while maintaining 98% specificity in control subjects. Other biomarkers, including micro-RNAs, ctDNA, methylated DNA, and combinations of ctDNA alterations, are being tested to provide an optimal first-stage test. New technologies are also being developed with greater sensitivity than TVS to image small volumes of tumor. See all articles in this CEBP Focus section, “NCI Early Detection Research Network: Making Cancer Detection Possible.”
AbstractList Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%–30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two-stage strategies have proven more effective, where a significant rise above a woman's baseline CA125 prompts TVS and an abnormal sonogram prompts surgery. Two major screening trials have documented that this strategy has adequate specificity, but sensitivity for early-stage (I–II) disease must improve to have a greater impact on mortality. To improve the first stage, different panels of protein biomarkers have detected cases missed by CA125. Autoantibodies against TP53 have detected 20% of early-stage ovarian cancers 8 months before elevation of CA125 and 22 months before clinical diagnosis. Panels of autoantibodies and antigen–autoantibody complexes are being evaluated with the goal of detecting >90% of early-stage ovarian cancers, alone or in combination with CA125, while maintaining 98% specificity in control subjects. Other biomarkers, including micro-RNAs, ctDNA, methylated DNA, and combinations of ctDNA alterations, are being tested to provide an optimal first-stage test. New technologies are also being developed with greater sensitivity than TVS to image small volumes of tumor. See all articles in this CEBP Focus section, “NCI Early Detection Research Network: Making Cancer Detection Possible.”
Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10-30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two stage strategies have proven more effective, where a significant rise above a woman’s baseline CA125 prompts TVS and an abnormal sonogram prompts surgery. Two major screening trials have documented that this strategy has adequate specificity, but sensitivity for early stage (I-II) disease must improve to have a greater impact on mortality. To improve the first stage, different panels of protein biomarkers have detected cases missed by CA125. Autoantibodies against TP53 have detected 20% of early stage ovarian cancers 8 months prior to elevation of CA125 and 22 months prior to clinical diagnosis. Panels of autoantibodies and antigen-autoantibody complexes are being evaluated with the goal of detecting >90% of early stage ovarian cancers, alone or in combination with CA125, while maintaining 98% specificity in control subjects. Other biomarkers, including micro-RNAs, ctDNA, methylated DNA, and combinations of ctDNA alterations are being tested to provide an optimal first stage test. New technologies are also being developed with greater sensitivity than TVS to image small volumes of tumor.
Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%-30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two-stage strategies have proven more effective, where a significant rise above a woman's baseline CA125 prompts TVS and an abnormal sonogram prompts surgery. Two major screening trials have documented that this strategy has adequate specificity, but sensitivity for early-stage (I-II) disease must improve to have a greater impact on mortality. To improve the first stage, different panels of protein biomarkers have detected cases missed by CA125. Autoantibodies against TP53 have detected 20% of early-stage ovarian cancers 8 months before elevation of CA125 and 22 months before clinical diagnosis. Panels of autoantibodies and antigen-autoantibody complexes are being evaluated with the goal of detecting >90% of early-stage ovarian cancers, alone or in combination with CA125, while maintaining 98% specificity in control subjects. Other biomarkers, including micro-RNAs, ctDNA, methylated DNA, and combinations of ctDNA alterations, are being tested to provide an optimal first-stage test. New technologies are also being developed with greater sensitivity than TVS to image small volumes of tumor.
Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%-30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two-stage strategies have proven more effective, where a significant rise above a woman's baseline CA125 prompts TVS and an abnormal sonogram prompts surgery. Two major screening trials have documented that this strategy has adequate specificity, but sensitivity for early-stage (I-II) disease must improve to have a greater impact on mortality. To improve the first stage, different panels of protein biomarkers have detected cases missed by CA125. Autoantibodies against TP53 have detected 20% of early-stage ovarian cancers 8 months before elevation of CA125 and 22 months before clinical diagnosis. Panels of autoantibodies and antigen-autoantibody complexes are being evaluated with the goal of detecting >90% of early-stage ovarian cancers, alone or in combination with CA125, while maintaining 98% specificity in control subjects. Other biomarkers, including micro-RNAs, ctDNA, methylated DNA, and combinations of ctDNA alterations, are being tested to provide an optimal first-stage test. New technologies are also being developed with greater sensitivity than TVS to image small volumes of tumor.See all articles in this CEBP Focus section, "NCI Early Detection Research Network: Making Cancer Detection Possible."Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%-30%. Used individually, neither serum CA125 nor transvaginal sonography (TVS) is sufficiently sensitive or specific. Two-stage strategies have proven more effective, where a significant rise above a woman's baseline CA125 prompts TVS and an abnormal sonogram prompts surgery. Two major screening trials have documented that this strategy has adequate specificity, but sensitivity for early-stage (I-II) disease must improve to have a greater impact on mortality. To improve the first stage, different panels of protein biomarkers have detected cases missed by CA125. Autoantibodies against TP53 have detected 20% of early-stage ovarian cancers 8 months before elevation of CA125 and 22 months before clinical diagnosis. Panels of autoantibodies and antigen-autoantibody complexes are being evaluated with the goal of detecting >90% of early-stage ovarian cancers, alone or in combination with CA125, while maintaining 98% specificity in control subjects. Other biomarkers, including micro-RNAs, ctDNA, methylated DNA, and combinations of ctDNA alterations, are being tested to provide an optimal first-stage test. New technologies are also being developed with greater sensitivity than TVS to image small volumes of tumor.See all articles in this CEBP Focus section, "NCI Early Detection Research Network: Making Cancer Detection Possible."
Author Lu, Karen H.
Lu, Zhen
Anderson, Karen S.
Han, Chae Young
Skates, Steven J.
Bast, Robert C.
Drescher, Charles W.
AuthorAffiliation 2 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas
3 Biodesign Institute, Arizona State University, Tempe, Arizona
4 Translational Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
5 Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
1 Department of Experimental Therapeutics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
AuthorAffiliation_xml – name: 2 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas
– name: 1 Department of Experimental Therapeutics, University of Texas M.D. Anderson Cancer Center, Houston, Texas
– name: 4 Translational Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
– name: 3 Biodesign Institute, Arizona State University, Tempe, Arizona
– name: 5 Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
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  givenname: Robert C.
  surname: Bast
  fullname: Bast, Robert C.
– sequence: 2
  givenname: Zhen
  surname: Lu
  fullname: Lu, Zhen
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  givenname: Chae Young
  surname: Han
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  surname: Lu
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/33051337$$D View this record in MEDLINE/PubMed
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Snippet Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%–30%. Used individually, neither...
Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10%-30%. Used individually, neither...
Early detection of ovarian cancer remains an important unmet medical need. Effective screening could reduce mortality by 10-30%. Used individually, neither...
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SubjectTerms Aged
Biomarkers, Tumor - metabolism
CA-125 Antigen - blood
DNA Methylation - genetics
Early Detection of Cancer - methods
Female
Humans
Middle Aged
Ovarian Neoplasms - diagnosis
Ovarian Neoplasms - diagnostic imaging
Ultrasonography - methods
Title Biomarkers and Strategies for Early Detection of Ovarian Cancer
URI https://www.ncbi.nlm.nih.gov/pubmed/33051337
https://www.proquest.com/docview/2451130959
https://pubmed.ncbi.nlm.nih.gov/PMC7710577
https://aacrjournals.org/cebp/article-pdf/29/12/2504/1946027/2504.pdf
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