Purpose: Novel biomarkers are urgently needed to increase the sensitivity of CA125 for the early detection of ovarian cancer. Indeed, it has been shown that as much as 20% of early-stage patients do not express significant levels of this biomarker.Therefore, the possibility of using autoantibodies directed against tumor-associated antigens as putative cancer markers is being more examined. Indeed, many autoantibodies have recently been shown to correlate with cancer patient prognosis or to be suitable for detection of the disease. Experimental Design: In this study, we have used a new approach involving the use of proteomics, immunology, and ELISA methods to identify relevant autoantibodies in the plasma of ovarian cancer patients. To do so, we developed an innovative technique called two-dimensional differential gel electrophoresis analysis of immunoprecipitated tumor antigens.Results: This strategy allowed us to successfully identify novel circulating autoantibodies directed against the S100A7 protein in the plasma of ovarian cancer patients. Further real-time reverse transcription-PCR and immunohistochemical studies confirmed that the S100A7 mRNA and protein were highly expressed in ovarian tumors but absent in normal and benign tissues. Moreover, a preliminary study involving 138 patients confirmed that the plasma levels of anti-S100A7 antibodies are significantly elevated in early-and late-stage ovarian cancer patients compared with healthy controls and with patients with benign gynecologic diseases. Conclusions: This shows that our approach is a valuable tool to successfully identify autoantibodies and tumor-associated antigens in cancer patients and that future research assessing their putative clinical usefulness would be worthwhile.Ovarian cancer is the leading cause of gynecologic cancer death worldwide. In the United States, it is the eighth most common cancer among women and the fifth most common cause of cancer death, with about 20,180 new cases and 15,310 deaths expected in 2006 (1). However, the relatively asymptomatic nature of early-stage disease and the lack of adequate screening tests have resulted in the majority of cases presenting with a late-stage disease (2). Currently, clinicians rely on a combination of serum CA125 levels and imaging to diagnose ovarian cancer in suspected patients and monitor treatment response. However, due to its low sensitivity, the currently used test to quantify the CA125 serum marker is not adequate for early detection (3). Indeed, up to 20% of ovarian cancers fail to express significant levels of the maker (4). Thus, there is an urgent need for new ovarian cancer biomarkers that could improve the sensitivity of ovarian cancer early detection.The hunt for cancer biomarkers in the serum/plasma of patients with cancer is based on the observation that some lowmolecular weight proteins that reflect the pathologic state of the patients are shed into the bloodstream (5). Therefore, because our immune system constantly surveys the body for ''nonself'' antigens,...