abstract: Serum HE4 as a diagnostic and prognostic marker for lung cancer (study included ovarian cancer patients)

Abstract

We evaluated the diagnostic and prognostic efficacy of human epididymis protein 4 (HE4) for lung cancer patients by using our novel enzyme-linked immunosorbent assay (ELISA) system. We measured serum HE4 levels of cancer patients including 49 lung cancer and 18 ovarian cancer patients. Furthermore, we evaluated the relationship between serum HE4 levels and overall survival after chemotherapy of 24 lung cancer patients. Serum HE4 levels were significantly higher for non-small, small cell lung cancer and ovarian cancer patients than for healthy controls. The area under the receiver operating characteristic curve (AUC) was calculated for differentiation of lung cancer patients and healthy controls. AUC for serum HE4 was 0.988 for differentiating lung cancer patients from healthy controls, with a cutoff value of 6.56 ng/ml (sensitivity = 89.8%, specificity = 100%).
Serum HE4 levels were elevated in 36/40 (90.0%) non-small cell lung cancer patients, 8/9 (88.9%) small cell lung cancer patients and 8/18 (44.4%) ovarian cancer patients. High levels of serum HE4 (>15 ng/ml) after chemotherapy were significantly correlated with worse overall survival after the treatment. These findings suggest that serum HE4 is a potential diagnostic and prognostic marker for lung cancer patients.

Chemoresponse Assay Could Lower Treatment Costs in Ovarian Cancer - ChemoFx

 "...In the study, the authors assumed, for the sake of analysis, that the "outcomes are likely no worse when chemoresponse testing is performed than when an empiric choice of regimen is made."
However, if, in currently ongoing studies, the assay helps clinicians choose more effective therapies and thus improve survival, it would be "very attractive from a health economics perspective," say the authors, because the current study has already shown it to be cost effective."
 
The study was funded by Precision Therapeutics.

(U.S.)Impact of a chemoresponse assay on treatment costs recurrent ovarian cancer

Abstract

OBJECTIVE: We sought to estimate mean costs of chemotherapy treatment for recurrent ovarian cancer with or without use of a chemoresponse assay.
STUDY DESIGN: We estimated mean costs for 3 groups: (1) assay assisted: 75 women who received oncologist's choice of chemotherapy following chemoresponse testing (65% adherence to test results), (2) assay adherent: modeled group assuming 100% adherence to assay results, and (3) empiric: modeled from market share data on most frequently utilized chemotherapy regimens. Cost estimates were based on commercial claims database reimbursements.
RESULTS: The most common chemotherapy regimens used were topotecan, doxorubicin, and carboplatin/paclitaxel. Mean chemotherapy costs for 6 cycles were $48,758 (empiric), $33,187 (assay assisted), and $23,986 (assay adherent). The cost savings related to the assay were associated with a shift from higher- to lower-cost chemotherapy regimens and lower use of supportive drugs such as hematopoiesis-stimulating agents.
CONCLUSION: Assay-assisted chemotherapy for recurrent ovarian cancer may result in reduced costs compared to empiric therapy.

Chemotherapy Resistance as a Predictor of Progression-Free Survival in Ovarian Cancer Patients Treated with Neoadjuvant Chemotherapy and Surgical Cytoreduction Followed by Intraperitoneal Chemotherapy: A Southwest Oncology Group Study

re: tumour assay testing
"Conclusions: While the small patient numbers in this trial do not permit definitive conclusions, these data fail to provide support for the argument that prospectively obtained in vitro data regarding platinum or paclitaxel resistance will be highly predictive of clinical outcome in advanced ovarian cancer."