A Multi-Biomarker Panel for Ovarian Cancer Screening — 20a — Amrita Bhagia, Megan Jorgensen, Maria Bell, and Pilar de la Puente

Ovarian cancer (OC) is a deadly disease, with the third highest mortality to incidence ratio of all cancers. OC’s asymptomatic nature causes identification at an advanced stage in over 70% of patients, at which point the 5-year survival rate is 20%. There is currently no approved biomarker for diagnosis of OC due to the lack of sensitivity and specificity in existing panels. While elevated levels of cancer antigen 125 (CA125) are used preoperatively to monitor patients, CA125 has a limited ability to detect early OC, and other benign conditions also have shown elevated CA125. Therefore, there is a critical need to develop sensitive and specific biomarkers for early diagnosis of OC in order to identify women at high risk for malignancy.

Methods: Plasma samples from a study population of 287 women with OC (at various stages), benign gynecological conditions, other tumor types, and healthy non-cancer controls were analyzed with a curated panel of biomarkers including CA125, Growth Differentiation Factor 15 (GDF15), Human Epididymis Protein 4 (HE4), Hepatocyte Growth Factor (HGF), Leukemia Inhibitory Factor (LIF), Interleukin-6 (IL-6), Osteopontin (OPN), and Prolactin (PRL). Receiver-operating characteristic (ROC) analysis was performed to assess the sensitivity and specificity of single and multiple biomarkers in the subgroups. 

Results/Conclusion: Multivariate analysis identified the panel containing CA125, GDF15, HE4, IL-6, OPN, and PRL as having the highest AUC when comparing controls and all stages of OC (AUC=0.956) and benign gynecological conditions (AUC=0.826). This same model also had high specificity and sensitivity when differentiating between early OC and controls (AUC = 0.896). These results validate a novel biomarker panel for early detection of OC and for distinguishing between benign and malignant ovarian masses. Our results are expected to have a positive impact by accurately detecting premalignant changes or early-stage OC in asymptomatic women.

University of South Dakota
Dr. Pilar de la Puente