TY - JOUR
T1 - Biomarkers and strategies for early detection of ovarian cancer
AU - Bast, Robert C.
AU - Lu, Zhen
AU - Han, Chae Young
AU - Lu, Karen H.
AU - Anderson, Karen S.
AU - Drescher, Charles W.
AU - Skates, Steven J.
N1 - Funding Information:
This work was supported by funds from the NCI Early Detection Research Network [5 U01 CA200462-02 (to R.C. Bast Jr), 5 U01 CA152990-09 (to S.J. Skates), the MD Anderson Ovarian SPOREs (P50 CA83639 and P50CA217685; to R.C. Bast Jr), National Cancer Institute, Department of Health and Human Services; the Cancer Prevention Research Institute of Texas (RP160145; to R.C. Bast Jr); Golfer's Against Cancer; the Tracey Joe Wilson Foundation; National Foundation for Cancer Research; The University of Texas MD Anderson Women's Moon Shot; and generous donations from the Ann and Henry Zarrow Foundation, the Mossy Foundation, the Roberson Endowment, Stuart and Gaye Lynn Zarrow, Barry Elson, Arthur and Sandra Williams, and the Concord (MA) Detect Ovarian Cancer Early Fund.
Publisher Copyright:
© 2020 American Association for Cancer Research.
PY - 2020/12
Y1 - 2020/12
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85100978889&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100978889&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-20-1057
DO - 10.1158/1055-9965.EPI-20-1057
M3 - Article
C2 - 33051337
AN - SCOPUS:85100978889
SN - 1055-9965
VL - 29
SP - 2504
EP - 2512
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 12
ER -