Abstract In 2012, an estimated 22,280 women will be diagnosed with ovarian cancer in the United States and 15,500 women will die from this disease. Though localized ovarian cancers have a survival rate of 92%, only 15-20% of ovarian cancers are detected at this stage. Developing an effective strategy for early detection could reduce mortality. While individual values of CA125 are neither sufficiently sensitive nor specific for early detection, monitoring CA125 over time shows greater specificity. The risk of ovarian cancer algorithm, ROCA, analyzes the trend of annual values for CA125, utilizing each woman's own baseline to refer a small fraction (<1-2%) of women to transvaginal sonography. Using this strategy, no more than three operations are required for each case of ovarian cancer detected. Use of multiple biomarkers might increase sensitivity for preclinical disease. Based on a multiplex assay of 96 biomarkers, a four biomarker panel was identified of CA125, HE4, MMP-7 and CA 72-4 with greater sensitivity than CA125 alone. To estimate the utility of these biomarkers for longitudinal screening, we assessed five annual longitudinal control serum samples from 200 women who did not develop ovarian cancer from the MDACC SPORE normal risk ovarian cancer screening study (NROSS). Utilizing WinBUGS, the inter-person and intra-person CVs were evaluated. Upon log transformation for CA125, HE4 and MMP-7 and log(log()+1) transformation for CA72-4, both the inter-person and intra-person CVs follow a log-normal distribution. The median inter-person CVs for CA125, HE4, MMP-7 and CA 72-4 were 49%, 20%, 35% and 84% respectively and the median intra-person CVs were 15%, 25%, 21% and 21% respectively. The ratios of intra-person CVs to inter-person CVs derived for CA125, HE4, MMP-7 and log(CA 72-4) were 0.31, 1.25, 0.6 and 0.31. We anticipate that the lower the ratio, the higher the contribution of each individual marker to early detection during longitudinal measurements. The intra-person CV's should permit development of a multi-marker algorithm. Assessment of longitudinal samples derived from 50 cases of preclinical ovarian cancer and 10 controls per case (UKCTOCS trial) are underway in order to establish such a longitudinal multi-marker algorithm for assessment of ovarian cancer risk. Citation Format: Archana Raamanathan, Zhen Lu, Robert C. Bast, Steven J. Skates. Intra-person and inter-person biomarker variation for modeling longitudinal values of ovarian cancer early detection biomarkers. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3473. doi:10.1158/1538-7445.AM2013-3473
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