Tumor Biology

, Volume 35, Issue 12, pp 12389–12395 | Cite as

Serum HE4 and CA125 as predictors of response and outcome during neoadjuvant chemotherapy of advanced high-grade serous ovarian cancer

  • Tuulia Vallius
  • Johanna Hynninen
  • Annika Auranen
  • Olli Carpén
  • Jaakko Matomäki
  • Sinikka Oksa
  • Johanna Virtanen
  • Seija Grénman
Research Article


Human epididymis protein 4 (HE4) is a novel tumour marker in epithelial ovarian cancer (EOC). Data on its profile and predictive potential for subsequent outcome after neoadjuvant chemotherapy (NACT) are still under investigation. The aim of this study was to compare CA125 and HE4 profiles with radiologic response after NACT and to evaluate their potential as predictors of clinical outcome in a primarily inoperable EOC patient cohort. Twenty-five EOC patients of high-grade subtype (HGSC) treated with NACT were enrolled in the study. Serum HE4 and CA125 samples were taken at the time of diagnosis and before interval debulking surgery (IDS). Pre-NACT and pre-IDS HE4 and CA125 and their percentage changes were compared with NACT response seen on CT and surgical outcome in IDS. We also evaluated the biomarkers’ abilities to predict platinum-free interval (PFI), progression-free survival (PFS) and overall survival (OS). All 25 patients were considered inoperable in laparoscopy at the time of diagnosis. HE4 and CA125 changes during NACT did not correlate with the changes seen on CT. Surgical outcome in IDS was associated with pre-IDS biomarker values but not with those taken before diagnosis. In IDS, 87 % had <1-cm residual tumour. In patients with HE4 change >80 and <80 % during NACT, the median OS was 3.38 and 1.60 years (p = 0.01), respectively. Serum HE4 is a promising additional tool when evaluating advanced HGSC patient’s response to NACT. It may be helpful when deciding whether to proceed to IDS or to second-line chemotherapy.


Ovarian high-grade serous cancer Neoadjuvant chemotherapy HE4 CA125 Treatment response Predictive value 



This study was financially supported by the Clinical Research (EVO) funding of Turku University Hospital. We are thankful to Pia Roering for the technical assistance with HE4 analyses.

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  • Tuulia Vallius
    • 1
  • Johanna Hynninen
    • 1
  • Annika Auranen
    • 1
  • Olli Carpén
    • 2
  • Jaakko Matomäki
    • 3
  • Sinikka Oksa
    • 4
  • Johanna Virtanen
    • 5
  • Seija Grénman
    • 1
  1. 1.Department of Obstetrics and Gynecology, Turku University HospitalUniversity of TurkuTurkuFinland
  2. 2.Department of PathologyUniversity of Turku and Turku University HospitalTurkuFinland
  3. 3.Department of Pediatrics, Turku University HospitalUniversity of TurkuTurkuFinland
  4. 4.Department of Obstetrics and GynecologySatakunta Central HospitalPoriFinland
  5. 5.Department of Radiology, Turku University HospitalUniversity of TurkuTurkuFinland

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