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

  • Research Article
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Tumor Biology

Abstract

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, 20520, Turku, Finland

    Tuulia Vallius, Johanna Hynninen, Annika Auranen & Seija Grénman

  2. Department of Pathology, University of Turku and Turku University Hospital, 20520, Turku, Finland

    Olli Carpén

  3. Department of Pediatrics, Turku University Hospital, University of Turku, 20520, Turku, Finland

    Jaakko Matomäki

  4. Department of Obstetrics and Gynecology, Satakunta Central Hospital, Pori, Finland

    Sinikka Oksa

  5. Department of Radiology, Turku University Hospital, University of Turku, 20520, Turku, Finland

    Johanna Virtanen

Authors
  1. Tuulia Vallius
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  2. Johanna Hynninen
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  3. Annika Auranen
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Correspondence to Tuulia Vallius.

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Vallius, T., Hynninen, J., Auranen, A. et al. Serum HE4 and CA125 as predictors of response and outcome during neoadjuvant chemotherapy of advanced high-grade serous ovarian cancer. Tumor Biol. 35, 12389–12395 (2014). https://doi.org/10.1007/s13277-014-2553-1

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  • DOI: https://doi.org/10.1007/s13277-014-2553-1

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