Protein Biomarkers of Ovarian Cancer: The Forest and The Trees

Abstract

The goal of effective population-based screening for ovarian cancer remains elusive despite intense efforts aimed at improving upon biomarker and imaging modalities. While dozens of potential serum biomarkers for ovarian cancer have been identified in recent years, none have yet overcome the limitations that have hindered the clinical use of CA-125. Avenues of opportunity in biomarker development are emerging as investigators are beginning to appreciate the significance of remote, as well as local or regional, sources of biomarkers in the construction of diagnostic panels, as well as the importance of evaluating biomarkers in prediagnostic settings. As the list of candidate biomarkers of ovarian cancer continues to grow, refinements in the methods through which specific proteins are selected for further development as components of diagnostic panels are desperately sought. Such refinements must take into account both the bioinformatic and biological significance of each candidate. Approaches incorporating these considerations may potentially overcome the challenges to early detection posed by the histological heterogeneity of ovarian cancer. Here, we review the recent progress achieved in efforts to develop diagnostic biomarker panels for ovarian cancer and discuss the challenges that remain.

Ovarian Cancer, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

“…32,[36][37][38] Randomized data do not yet support routine screening for ovarian cancer in the general population, and routine screening is not currently recommended by any professional society. 32,35,[39][40][41][42][43][44][45][46] Some physicians follow-up women with high-risk factors (eg, BRCA mutations, family history) using cancer antigen 125 (CA 125) monitoring and endovaginal ultrasound 39 ; however, prospective validation of these tests remains elusive.…”

Diagnosis and preoperative predictive value of serum HE4 concentrations for optimal debulking in epithelial ovarian cancer

“…Early diagnosis of ovarian cancer is likely to improved the cure rate significantly. At present, the sensitivity and specificity of the clinically used markers of ovarian cancer are low for early diagnosis, so a number of studies have attempted to identify a more effective diagnostic marker (3). Human epididymis protein 4 (human epididymis gene product 4; HE4) is a marker of ovarian tumors which has significant potential for diagnosis (4).…”

A longitudinal analysis with CA-125 to predict overall survival in patients with ovarian cancer

“…However, the exact relationship between CA-125 and OS is still unclear [14,15]. Many of the related studies focus on specific values of CA-125.…”