A Perspective on Ovarian Cancer Biomarkers: Past, Present and Yet-To-Come

Abstract

The history of biomarkers and ultrasonography dates back over more than 50 years. The present status of biomarkers used in the context of ovarian cancer is addressed. Attention is given to new interpretations of the etiology of ovarian cancer. Cancer antigen 125 (CA125) and multivariate index assays (Ova1, Risk of Ovarian Malignancy Algorithm, Overa) are biomarker-driven considerations that are presented. Integration of biomarkers into ovarian cancer diagnostics and screening are presented in conjunction with ultrasound. Consideration is given to the serial application of both biomarkers and ultrasound, as well as morphology-based indices. Attempts are made to foresee how individualized molecular signatures may be able to both provide an alert of the potential for ovarian cancer and to provide molecular treatments tailored to a personalized genetic signature. In the future, an annual pelvic ultrasound and a comprehensive serum biomarker screening/diagnostic panel may replace the much maligned bimanual examination as part of the annual gynecologic examination. Taken together, it is likely that a new medical specialty for screening and early diagnostics will emerge for physicians and epidemiologists, a field of study that is independent of patient gender, organ, or the subspecialties of today.

The Challenges and Opportunities of LncRNAs in Ovarian Cancer Research and Clinical Use

“…As mentioned above, there are currently no efficient and routine methods for early diagnosis of OC. Only in a minority of cases, wherein the condition is suspected on the basis of either unspecific symptoms or familial antecedents, can preventive measures be taken, such as gynecological explorations; imaging techniques, such as transvaginal sonography; or blood tests to measure cancer antigen 125 (CA-125) together with other proteins with informative value, such as transferrin or HE4 [3]. If a tumor is detected, further and more sophisticated explorations are conducted: imaging techniques such as computed tomography (CT) or positron emission tomography (PET), and laparotomy or surgery to: (i) extract a sample for biopsy/histology-based diagnosis, (ii) study the extent of the disease (localized or generalized-staging) and/or (iii) proceed with therapeutic surgical debulking/cytoreductive surgery of the tumor [4].…”

“…If a tumor is detected, further and more sophisticated explorations are conducted: imaging techniques such as computed tomography (CT) or positron emission tomography (PET), and laparotomy or surgery to: (i) extract a sample for biopsy/histology-based diagnosis, (ii) study the extent of the disease (localized or generalized-staging) and/or (iii) proceed with therapeutic surgical debulking/cytoreductive surgery of the tumor [4]. These techniques are either nonspecific or only valid for late detection [3].…”

“…In contrast, early diagnosis correlates with a much better prognosis. Unfortunately, no early biomarkers have been approved for clinical use so far, although some attempts have been made using multivariate index assays, such as the risk of ovarian malignancy algorithm (ROMA) or Overa [3]. The first-line treatment of OC consists of surgical resection of the tumor and administration of platinum derivatives, taxanes and/or bevacizumab, which is a monoclonal antibody targeting vascular endothelial cell growth factor (VEGF).…”

Design of a New Peptide Substrate Probe of the Putative Biomarker Legumain with Potential Application in Prostate Cancer Diagnosis Ex Vivo

“…Early diagnosis of Pca is usually reliant on techniques that include digital rectal examination, magnetic resonance imaging and transrectal ultrasound-guided biopsy in conjunction with screening for serum levels of prostate specific antigen (PSA) which remains the principal biomarker for Pca (Zhang et al 2017). A challenge across the spectrum of cancers is to identify and incorporate into clinical practice, well-defined and validated diagnostic and predictive biomarkers of disease (Dijkstra et al 2012;Hemminki et al 2012;Selvolini and Marrazza 2017;Ueland 2017).…”

Human Antibody Fusion Proteins/Antibody Drug Conjugates in Breast and Ovarian Cancer

“…In view of this, imaging modalities, e.g. magnetic resonance imaging (MRI), CT scanning and ultrasound techniques, have played a significant role in the field of surgical image guidance, especially during endoscopy [85,86]. …”