Detection of CA125-Negative Persistent and Recurrent Ovarian Cancer

Project summary

CA125, an ovarian cancer blood test, can detect persistence or recurrence of ovarian cancer (OC) after initial surgery and chemotherapy, but is not optimally sensitive to detect small amounts of cancer. Second-look surgery (SLS) can detect persistent cancer in ~50% of cases with normal CA125 (35 U/ml) can detect recurrence of OC after treatment with conventional chemotherapy in >70% of cases with > 4 months lead time. CA125 is, however, less effective in detecting recurrence in women on PARP inhibitors. My previous studies showed that the addition of three biomarkers (HE4, HE4 antigen-autoantibody complexes, and osteopontin) to CA125 could increase sensitivity for early stage OC from 72% to 91%. Our collaborators in Toronto have found 21 biomarkers that detect recurrent cancer. In Aim 1, we will identify blood tests that detect small amounts of residual ovarian cancer at the time of second look operations that are missed by CA125. In Aim 2, we will find novel blood tests that detect recurrent disease sooner than CA125. In Aim 3, we will find why CA125 misses recurrence in patients on PARP inhibitors. Detection of persistent or recurrent ovarian cancer sooner, will provide time for women to receive and benefit from both conventional and the many novel treatments that are now available, providing longer, better survival and testing new targeted therapy and immunotherapy more promptly.

This grant was made possible in part by generous donations from Ovarian Cycle Orlando in memory of Kelly, Carol M., Carol T., Adi, Rose, Judi, Vicky, Terry, Wendy, Adriana and their Teal Angels, and Ovarian Cycle Tampa in loving memory of Franci Golman Rudolph and Suzanne Maloney.