title: Serum HE4 and CA125 as predictors of response and outcome during neoadjuvant chemotherapy of advanced high-grade serous ovarian cancer.
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.
authors.affiliation: Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, 20520, Turku, Finland, tamval@utu.fi.
authors.forename: Tuulia
authors.initials: T
authors.lastname: Vallius
authors.forename: Johanna
authors.initials: J
authors.lastname: Hynninen
authors.forename: Annika
authors.initials: A
authors.lastname: Auranen
authors.forename: Olli
authors.initials: O
authors.lastname: Carpén
authors.forename: Jaakko
authors.initials: J
authors.lastname: Matomäki
authors.forename: Sinikka
authors.initials: S
authors.lastname: Oksa
authors.forename: Johanna
authors.initials: J
authors.lastname: Virtanen
authors.forename: Seija
authors.initials: S
authors.lastname: Grénman
mesh_terms: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen / Q000097:blood*; D000077216:Carcinoma, Ovarian Epithelial; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000097:blood / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D011506:Proteins / Q000378:metabolism*; D016896:Treatment Outcome; D000081102:WAP Four-Disulfide Core Domain Protein 2
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D011506:Proteins; D000081102:WAP Four-Disulfide Core Domain Protein 2; C569698:WFDC2 protein, human