title: Can HE4 predict platinum response during first-line chemotherapy in ovarian cancer?
abstract: Actually, in literature there are not valid tools able to predict the chemotherapy response during first-line ovarian cancer treatment. CA125 and human epididymis protein 4 (HE4) levels of consecutive single-institution patients with epithelial ovarian cancer (EOC) were measured during first-line chemotherapy and until 6 months follow-up. First, patients were divided into two groups according to a temporal criterion: patients treated during 2009 (group A: training group) and patients treated during 2010 (group B: verification group). At sixth months follow-up, patients were sub-classified, within both groups, as platinum resistant or platinum sensitive/intermediate, according to Response Evaluation Criteria in Solid Tumors criteria, and the serum marker courses were further analyzed in each subgroup. Moreover, we performed a logistic regression analysis to choose CA125 and HE4 levels that are best fitted to predict chemoresponse. A total of 76 patients were divided into two groups: group A (n = 42) and group B (n = 34). After 6 months of follow-up, 40 patients were classified as platinum sensitive/intermediate and 36 as platinum resistant. At third chemotherapy cycle, in platinum-resistant patients, HE4 levels were >70 pmol/L in 36 of 36 cases, although in platinum-sensitive/intermediate patients, HE4 levels were >70 pmol/L only in six of 40 cases (sensitivity 100 %, specificity 85 %). Moreover, HE4 reduction of almost 47 % at third chemotherapy cycle reached the sensitivity of 83 % with a specificity of 87 % (positive predictive value = 0.86, negative predictive value = 0.85) in predicting chemoresponse. On the contrary, CA125 values during chemotherapy did not result statistically significant in predicting platinum response. Our findings suggest that HE4 values during first-line chemotherapy could predict chemotherapy response in EOC patients.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Rome "Campus Bio-Medico", Via Alvaro del Portillo, 200, 00128, Rome, Italy, r.angioli@unicampus.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Angioli
authors.forename: Stella
authors.initials: S
authors.lastname: Capriglione
authors.forename: Alessia
authors.initials: A
authors.lastname: Aloisi
authors.forename: Federica
authors.initials: F
authors.lastname: Guzzo
authors.forename: Daniela
authors.initials: D
authors.lastname: Luvero
authors.forename: Andrea
authors.initials: A
authors.lastname: Miranda
authors.forename: Patrizio
authors.initials: P
authors.lastname: Damiani
authors.forename: Roberto
authors.initials: R
authors.lastname: Montera
authors.forename: Corrado
authors.initials: C
authors.lastname: Terranova
authors.forename: Francesco
authors.initials: F
authors.lastname: Plotti
mesh_terms: D000328:Adult; D000368:Aged; D054316:Biomarkers, Pharmacological / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D019008:Drug Resistance, Neoplasm / Q000187:drug effects / Q000235:genetics; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D010984:Platinum / Q000627:therapeutic use; D011379:Prognosis; D011506:Proteins / Q000235:genetics / Q000378:metabolism*; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D054316:Biomarkers, Pharmacological; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human; D010984:Platinum
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