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Plasma concentrations of the vitamin E-binding protein afamin are associated with overall and progression-free survival and platinum sensitivity in serous ovarian cancer – A study by the OVCAD consortium
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Abstract
Objective
Comparative
proteomics identified the plasma protein afamin as potential biomarker
for ovarian cancer (OC). Significantly decreased afamin plasma
concentrations in pre-therapeutic OC patients reconstituted to control
values after successful tumor surgery. This study evaluates the
association of afamin with survival and response to therapy in serous OC
patients within the OVCAD consortium project.
Methods
We
measured afamin in 215 pre-therapeutic plasma samples, 246 tumor
lysates and 109 plasma samples taken six months after finishing
platinum-based chemotherapy. Differences in afamin plasma concentrations
among FIGO stages were tested by Kruskal Wallis test; association of
afamin concentrations with overall and progression-free survival was
evaluated using Kaplan-Meier survival plots and multivariate adjusted
COX regression analysis.
Results
Pre-therapeutic
afamin correlated significantly with FIGO stages (p = 0.012) and was
lower in the presence of metastases (p = 0.013) and poorly
differentiated OC in patients responding to therapy (p = 0.016). Afamin
≥ 48.0 mg/L was also associated with a lower hazard ratio for recurrent
disease as compared to afamin < 48.0 mg/L (p = 0.007).
Post-therapeutic afamin ≥ 48 mg/L was positively correlated with overall
(p < 0.001) and progression-free (p = 0.012) survival and was lower
in non-responders than in responders (p = 0.048). Thus, afamin returned
post-therapeutically to values of healthy controls in responders
(p < 0.001) but not in non-responders (p = 0.114). Afamin in tumor
lysates was lower in poorly differentiated OC than in G 1 + 2 tumors
(p = 0.041). Higher afamin concentrations in tumor lysates were
associated with increased overall survival (p = 0.003).
Conclusion
These data indicate that afamin is associated with therapy response and survival rate in advanced OC patients.
Highlights
►
The plasma protein afamin is evaluated as prognostic tumor marker for
ovarian cancer
► Afamin plasma concentrations are associated with response to therapy and survival
► Afamin may therefore serve as therapy monitoring for estimation of disease progression
► Afamin plasma concentrations are associated with response to therapy and survival
► Afamin may therefore serve as therapy monitoring for estimation of disease progression
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