A1 Refereed original research article in a scientific journal
HE4 in the evaluation of tumor load and prognostic stratification of high grade serous ovarian carcinoma
Authors: Liina Salminen, Kamlesh Gidwani, Seija Grènman, Olli Carpén, Sakari Hietanen, Kim Pettersson, Kaisa Huhtinen, Johanna Hynninen
Publisher: TAYLOR & FRANCIS LTD
Publication year: 2020
Journal: Acta Oncologica
Journal name in source: ACTA ONCOLOGICA
Journal acronym: ACTA ONCOL
Volume: 59
Issue: 12
First page : 1461
Last page: 1468
Number of pages: 8
ISSN: 0284-186X
eISSN: 1651-226X
DOI: https://doi.org/10.1080/0284186X.2020.1827157(external)
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/50710840(external)
Objective Human epididymis protein 4 (HE4) is a validated, complementary biomarker to cancer antigen 125 (CA125) for high grade serous ovarian carcinoma (HGSC). Currently, there are insufficient data on the utility of longitudinal HE4 measurement during HGSC treatment and follow up. We set to provide a comprehensive analysis on the kinetics and prognostic performance of HE4 with serial measurements during HGSC treatment and follow up. Methods This prospective study included 143 patients with advanced HGSC (ClinicalTrials.gov identifier: NCT01276574). Serum CA125 and HE4 were measured at baseline, before each cycle of chemotherapy and during follow up until first progression. Baseline biomarker values were compared to the tumor load assessed during surgery and to residual disease. Biomarker nadir values and concentrations at progression were correlated to survival. Results The baseline HE4 concentration distinguished patients with a high tumor load from patients with a low tumor load assessed during surgery (p<.0001). The baseline CA125 level was not associated with tumor load to a similar extent (p=.067). At progression, the HE4 level was an independent predictor of worse survival in the multivariate analysis (p=.002). All patients that were alive 3 years post-progression had a serum HE4 concentration below 199.20 pmol/l at the 1st recurrence. Conclusion HE4 is a feasible biomarker in the treatment monitoring and prognostic stratification of patients with HGSC. Specifically, the serum level of HE4 at first relapse was associated with the survival of patients and it may be a useful complementary tool in the selection of second line treatments. This is to the best of our knowledge the first time this finding has been reported.
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