Kinetics of HE4 and CA125 as prognosis biomarkers during neoadjuvant chemotherapy in advanced epithelial ovarian cancer

Abstract

Background Ovarian cancer (OC) is considered the most lethal gynecological cancer, of which more than 65% cases are diagnosed in advanced stages, requiring platinum-based neoadjuvant chemotherapy (NACT). Methods A prospective-longitudinal study was conducted among women with advanced epithelial ovarian cancer (AEOC), III and IV stages, and treated with NACT, at the National Cancer Institute – Mexico, from July 2017 to July 2018. Serum samples were obtained for quantification of CA125 and HE4 using ELISA at the first and in each of the three NACT cycles. The therapeutic response was evaluated through standard tomography. We determined whether CA125 and HE4, alone or in combination, were associated with TR to NACT during follow up. Results 53 patients aged 38 to 79 years were included, 92.4% presented papillary serous subtype OC. Higher serum HE4 levels were observed in patients with non-tomographic response (6.89 vs 5.19 pmol/mL; p = 0.031), specially during the second (p = 0.039) and third cycle of NACT (p = 0.031). Multivariate-adjusted models showed an association between HE4 levels and TR, from the second treatment cycle (p = 0.042) to the third cycle (p = 0.033). Changes from baseline HE4 levels during the first cycle was negative associated with TR. No associations were found between CA125 and TR. Conclusions Serum HE4 levels were independently associated with TR among patients with AOEC treated with NACT, also a reduction between baseline HE4 and first chemotherapy levels was also independently associated with the TR. These findings might be relevant for predicting a lack of response to treatment.

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

“…CA125 is a common biomarker in patients with ovarian cancer, which is of certain significance in diagnosis and prognosis. However, recent research showed that there was no significant correlation between CA125 and the efficacy of neoadjuvant chemotherapy in patients with ovarian cancer ( 7 ), necessitating the identification of biomarkers to predict the efficacy of neoadjuvant chemotherapy in ovarian cancer. The systemic immune-inflammation index (SII), reflecting the immune and inflammatory status of patients with malignant tumors, has been used in the diagnosis and treatment of a variety of malignant tumors and has been found to be related to the prognosis of patients ( 8 - 10 ).…”

Screening and identification of serum exosomal protein ZNF587B in liquid biopsy for ovarian cancer diagnosis

“…Ovarian cancer (OC) bears the highest mortality rate among gynecological malignancies [1]. At the time of diagnosis, 60-70% of patients present at an advanced stage, with a 5-year survival rate ranging between 20-30% [2]. Currently, clinical diagnosis and screening primarily rely on a combination of the serum tumor marker CA125 and transvaginal ultrasound.…”

The role of inflammatory factors and T‐cell subsets in the diagnosis of recurrence in epithelial ovarian cancer patients and the effect of olaparin treatment on them

“…Serum human epididymis secretory protein‐4 (HE4) is one of the most sensitive tumor markers of ovarian cancer found in recent years. Its serum level can be used as a good index to monitor the recurrence of ovarian cancer patients after chemotherapy 21 . The role of interleukin‐6 (IL‐6), tumor necrosis factor‐α (TNF‐α), and IFN‐γ in the development of ovarian cancer has attracted much attention 22 …”

“…Its serum level can be used as a good index to monitor the recurrence of ovarian cancer patients after chemotherapy. 21 The role of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and IFN-γ in the development of ovarian cancer has attracted much attention. 22 Therefore, this study compared the proportion of serum cytokines and T-lymphocyte subsets in recurrent and nonrecurrent epithelial ovarian cancer patients.…”

“…Its serum level can be used as a good index to monitor the recurrence of ovarian cancer patients after chemotherapy. 21 The role of interleukin‐6 (IL‐6), tumor necrosis factor‐α (TNF‐α), and IFN‐γ in the development of ovarian cancer has attracted much attention. 22 …”