Developing a Test of Uterine Lavage for the Detection of Ovarian Cancer

NCT04794322RecruitingOBSERVATIONAL

Summary

Key Facts

Lead Sponsor

Massachusetts General Hospital

Enrollment

250

Start Date

2020-04-13

Completion Date

2027-08-31

Study Type

OBSERVATIONAL

Official Title

Ovarian Cancer Detection by Uterine Lavage DNA and Serum Proteins: a Phase 2 Biomarker Study

Interventions

Uterine lavageor a wash of the wombBlood samplePap smear

Conditions

Ovarian NeoplasmsOvarian Epithelial CarcinomaFallopian Tube NeoplasmsHigh Grade Ovarian Serous AdenocarcinomaStage I Ovarian CancerStage II Ovarian CancerStage III Ovarian Cancer AJCC v8Stage IIIA Ovarian Cancer AJCC v8Stage IIIA1 Ovarian Cancer AJCC v8Stage IIIA2 Ovarian Cancer AJCC v8Stage IIIB Ovarian Cancer AJCC v8Stage IIIC Ovarian Cancer AJCC v8Stage IV Ovarian Cancer AJCC v8Stage IVA Ovarian Cancer AJCC v8Stage IVB Ovarian Cancer AJCC v8

Eligibility

Age Range

30 Years+

Sex

FEMALE

Inclusion Criteria:

* Has intact uterus (no history of uterine ablation, tubal ligation or bilateral salpingectomy)
* Cohort 1 (n=200 participants): Women scheduled for surgery or diagnostic laparoscopy for suspected but undiagnosed ovarian/fallopian tube cancer
* Cohort 2 (n=50 participants): Known BRCA1 or BRCA2 mutation carrier scheduled for risk-reducing salpingo-oophorectomy

Exclusion Criteria:

* Current tissue or cytology diagnostic procedure positive for ovary cancer or any cancer
* Inability to provide informed consent
* Age less than 30 years
* Inability to obtain the minimum amount of blood
* Inability to obtain the minimum amount of uterine lavage sample
* At risk if blood were drawn (e.g. hemophilia, serious anemia- Hb less than 8.0 gm/dL)
* Prior history of known ovarian or endometrial cancer
* Treatment less than 1 year (excluding hormonal therapy) for cancer that spread beyond its origin
* History of untreated high-grade cervical dysplasia (CIN3)
* History of treated high grade cervical dysplasia (CIN3) with a cytologically abnormal pap smear within the past year. If there is no post treatment Pap smear in the medical record, perform a Pap smear prior to the day of surgery. If this Pap smear is abnormal, the participant is ineligible.
* Currently pregnant
* Known Lynch syndrome

Outcome Measures

Primary Outcomes

Genomic biomarkers assessing mutations and methylation of tumor DNA, and protein biomarkers measured as the concentration of a protein in pg/mL, both types of biomarkers measured in the collected biospecimens.

Biomarkers that distinguish between ovarian cancer and benign ovarian disease

Time frame: From enrollment through to pathology results post-surgery (usually same day)

Locations

University of Arkansas for Medical Sciences, Little Rock, United States

Kaiser Permanente - San Francisco, San Francisco, United States

Anne Arundel Health System, Annapolis, United States

Johns Hopkins University School of Medicine, Baltimore, United States

Massachusetts General Hospital, Boston, United States

The Swedish Hospital, Seattle, United States

Linked Papers

2024-01-04

Early Ovarian Cancer Detection in the Age of Fallopian Tube Precursors

OBJECTIVE: To determine biomarkers other than CA 125 that could be used in identifying early-stage ovarian cancer. DATA SOURCES: Ovid MEDLINE ALL, EMBASE, Web of Science Core Collection, ScienceDirect, Clinicaltrials.gov, and CAB Direct were searched for English-language studies between January 2008 and April 2023 for the concepts of high-grade serous ovarian cancer, testing, and prevention or early diagnosis. METHODS OF STUDY SELECTION: The 5,523 related articles were uploaded to Covidence. Screening by two independent reviewers of the article abstracts led to the identification of 245 peer-reviewed primary research articles for full-text review. Full-text review by those reviewers led to the identification of 131 peer-reviewed primary research articles used for this review. TABULATION, INTEGRATION, AND RESULTS Of 131 studies, only 55 reported sensitivity, specificity, or area under the curve (AUC), with 36 of the studies reporting at least one biomarker with a specificity of 80% or greater specificity or 0.9 or greater AUC. CONCLUSION: These findings suggest that although many types of biomarkers are being tested in ovarian cancer, most have similar or worse detection rates compared with CA 125 and have the same limitations of poor detection rates in early-stage disease. However, 27.5% of articles (36/131) reported biomarkers with better sensitivity and an AUC greater than 0.9 compared with CA 125 alone and deserve further exploration.