| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3945246 | Gynecologic Oncology | 2012 | 5 Pages |
ObjectiveEvaluate and compare the effectiveness of CA125, HE4, Mesothelin and MMP7 marker levels to monitor ovarian cancer patients after surgery and chemotherapy. Evaluate the lead time of a rise of marker levels before recurrence.MethodsThe study consists of 23 patients with advanced stage ovarian/fallopian tube cancer. Blood was drawn after front line surgery and chemotherapy treatment and at 3 month intervals thereafter. One patient had chemoresistant disease, two patients remained in remission and 20 patients had recurring disease and were used for marker evaluation.ResultsIn five patients HE4 was the only marker to elevate before recurrence with a lead time of up to 4½ months including one patient who did not have a CA125 response at all. In a further two patients, HE4 increased before CA125 did. In four of these seven patients, HE4 levels were consistently at or above threshold during remission when both CA125 and imaging results were negative. MMP7 elevated before recurrence in one patient who was negative for the other markers. Mesothelin elevated in two patients who were also positive for CA125 and HE4.ConclusionsHE4 can predict ovarian cancer recurrence earlier than CA125 and it can be elevated in patients that do not express CA125 at sufficient levels to make a clinical decision. MMP7 and Mesothelin have lower potential as markers for ovarian cancer recurrence to complement CA125. A failure of HE4 levels to normalize at completion of standard therapy may indicate a poor prognosis.
Graphical abstractFigure optionsDownload full-size imageDownload as PowerPoint slideHighlights► Three new markers were compared to CA125 for lead time to ovarian cancer recurrence. ► HE4 elevates at recurrence when CA125 does not. ► Mesothelin has less marker potential, MMP7 shows promise and requires confirmation.
