Ovarian Cancer Blood Test May Eliminate Need for Diagnostic Exploratory Surgery

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A liquid biopsy test has detected changes in the BRCA1 or BRCA2 genes associated with ovarian and breast cancer that signal when the disease stops responding to treatment through platinum chemotherapy or poly ADP-ribose polymerase (PARP) inhibitors. [Source: © freshidea/Fotolia]

Scientists at Uppsala University and the Sahlgrenska Academy, University of Gothenburg say they have developed a blood test that may provide a more precise diagnostic for suspected ovarian cancer that would eliminate the need for exploratory surgery. This could lead to a reduction in unnecessary surgery and to earlier detection and treatment for affected women, noted the researchers whose study (High throughput proteomics identifies a high-accuracy 11 plasma protein biomarker signature for ovarian cancer) was published in Communications Biology.

“Ovarian cancer is usually detected at a late stage and the overall 5-year survival is only 30–40%. Additional means for early detection and improved diagnosis are acutely needed. To search for novel biomarkers, we compared circulating plasma levels of 593 proteins in three cohorts of patients with ovarian cancer and benign tumors, using the proximity extension assay (PEA). A combinatorial strategy was developed for identification of different multivariate biomarker signatures. A final model consisting of 11 biomarkers plus age was developed into a multiplex PEA test reporting in absolute concentrations,” the investigators wrote.

“The final model was evaluated in a fourth independent cohort and has an AUC = 0.94, PPV = 0.92, sensitivity = 0.85, and specificity = 0.93 for detection of ovarian cancer stages I–IV. The novel plasma protein signature could be used to improve the diagnosis of women with adnexal ovarian mass or in screening to identify women that should be referred to specialized examination.

“We need to develop more accurate pre-surgery diagnostics. To detect one cancer, we operate on up to five women—yet this is currently the best option when abnormalities are detected by ultrasound and cancer is suspected. There is a great need for a simple blood test that could identify women who do not need surgery,” said Karin Sundfeldt, MD, PhD, professor and senior consultant at the department of obstetrics and gynecology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg.

The biomarker profile can also detect borderline cases and early stages of the disease.

“Our results are promising enough to consider screening for early discovery of ovarian cancer. In Sweden, we have a lot of experience screening for cervical cancer. I see great prospects of developing a strategy for screening for ovarian cancer as well, which could save lives and minimize the need for surgery to rule out cancer,” added Ulf Gyllensten, PhD, professor of medical molecular genetics at the department of immunology, genetics and pathology at Uppsala University. “We are now continuing to evaluate the test and are performing a large-scale study of samples collected at all hospitals from the western region and Halland healthcare system.”

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