Blogger's Note/Opinion:
efforts to improve on the existing CA125 biomarkers remain elusive, as we speak; this may be confirmed by the multitude of research studies/meta-analsyes (
known issues);
we, as patients/survivors, all have examples which are contrary, or exceptions, to what is presently known and therefore the issue of 'personalized medicine'; biomarker banking (tissues from surgery for research) is an important key element for those diagnosed so that we may move forward beyond the standard CA125 (as one example); on the bonus side - research is moving forward at a greatly accelerated pace (molecular/proteomics...) but the research is still in the phase/s of being brought to the 'clinic', meaning what actually works for our ovarian cancer women pre-present-post diagnosis; it is a
common philosophy in ovarian cancer research that due to our low numbers (relative to other cancers) that we must have global research (not least of which is to mention global economics);
as patients you can make a difference by ensuring that the clinical studies which you enroll will make a difference in these efforts as opposed to small isolated studies - specifically those that continue to
regurgitate past studies which
do not move forward beyond the existing eg. psychosocial aspects of prophlactic surgery
Proteomic biomarkers in combination with CA 125 for detection of epithelial ovarian cancer using prediagnostic serum samples from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial - Moore - 2011 - Cancer
RESULTS (abstract):
"CA
125 levels were elevated (≥35 U/mL) in 61.5% of 65 patients who had CA
125 data available from samples that were collected <12 months before
cancer diagnosis; however, levels of the additional 7 biomarkers were
not different between cases and the 3 control groups individually or
combined. Two panels that combined CA 125 and the 7 biomarkers failed to
improve the sensitivity of CA 125 alone."
DISCUSSION
".....Although a marginally better performance was observed for the
identification of cases at least 6 months before diagnosis using an
all-site multimarker panel (which included CA 125, HE4, tumor-associated
glycoprotein 72 [CA 72-4], substance P-like immunoreactivity, andĪ²2M)
were observed compared with CA 125 alone, the increase was not
statistically significant.
21 In addition to the current study, 5 additional panels were evaluated, none of which improved on the results with CA 125 alone.
8
Considering the failure of multiple biomarkers to improve upon CA 125
in prediagnostic samples, new approaches are badly needed for biomarker
discovery. One weakness of the current study is that we were unable to
evaluate markers in nonwhite populations because of a very small number
of nonwhite cases in the PLCO trial. The results of this combined effort
will likely reshape our approach to biomarker discovery and validation.
In addition to searching for protein analytes, autoantibodies also may
be sought. Finally, previous studies have had limited success in
identifying and evaluated autoantibodies of human proteins expressed in
bacteria or insect cells. Recent advances in expressing human proteins
in human cells could allow the identification of new epitopes that are
selective for altered tertiary structure and glycosylation status of
selected protein targets."
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