Early markers of ovarian cancer

Concentrations of three biomarkers begin to rise three years before women are diagnosed ovarian cancer, according to a new study by Public Health Sciences Division researchers published online Dec. 30 in the Journal of the National Cancer Institute. However, the study found the biomarkers become substantially elevated only in the last year prior to diagnosis.

The findings, led by Drs. Garnet Anderson and Nicole Urban, expand on previous research into biomarkers known as CA125, HE4, mesothelin, B7-H4, decoy receptor 3, and spondin-2. Although all have been identified as potential ovarian cancer biomarkers, their behavior in the pre-diagnostic period (with the exception of CA125) had not been evaluated previously.

Using blood samples from the Carotene and Retinol Efficacy Trial, a previous Hutchinson Center-run lung cancer study, the researchers compared samples from 34 women who were diagnosed with ovarian cancer to samples from 70 healthy patients.

The concentrations of CA125, HE4, and mesothelin increased slightly in cancer patients about three years before diagnosis. But at that early stage, the levels weren’t high enough to accurately predict the disease, the researchers found. A high degree of accuracy is required for such tests, they wrote, “because a definitive diagnosis requires surgery.”

In an accompanying editorial, Dr. Patricia Hartge of the National Cancer Institute said the study took the field one step closer to successful screening designs by showing that the levels of certain biomarkers do not increase early enough to be used for screening.

“Serum markers likely will form a key element in any screening regimen, with the lead time and other parameters of each marker or combination of markers being taken into account,” she said. “The careful evaluation technique applied in the current study fits into a staged approach necessary for testing performance of early markers of disease.”
 
[Adapted from a JNCI news release.]