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The effectiveness of CA125 and HE4 as clinical prognostic markers in epithelial ovarian cancer patients with BRCA
Young Joo Lee1, Woojin Kim2,3, Soomin Hong1
1Department of Obstetrics and Gynecology, Women's Cancer Center, Yonsei Cancer Center, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Normalizing cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) effectively predicts recurrence in epithelial ovarian cancer, regardless of BRCA mutations. A negative HE4 result is a useful predictor for recurrence-free survival in BRCA-mutated patients.
Area of Science:
- Oncology
- Biomarker Research
- Gynecologic Oncology
Background:
- Epithelial ovarian cancer (EOC) survival is influenced by BRCA mutational status.
- CA125 and HE4 are established biomarkers in ovarian cancer management.
- Predictive markers for recurrence are crucial for personalized treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of CA125 and HE4 in predicting survival outcomes in EOC patients.
- To assess the impact of BRCA mutational status on the predictive power of CA125 and HE4.
- To identify optimal biomarker thresholds for predicting 1-year recurrence-free survival.
Main Methods:
- Retrospective analysis of 423 EOC patients' medical records.
- Assessment of CA125 and HE4 levels post-surgery and chemotherapy.
- Utilized Area Under the Curve (AUC), sensitivity, specificity, and Kaplan-Meier analysis to evaluate predictive accuracy.
Main Results:
- CA125 and HE4 normalization showed high specificity in predicting 1-year survival across BRCA mutation statuses.
- Normalizing HE4 alone demonstrated prognostic value (AUC 0.774) in BRCA-mutated patients.
- Specificities for normalization varied between PDS (97.1-99.1%) and IDS (78.6-86.2%) groups.
Conclusions:
- Combined normalization of CA125 and HE4 is the most effective predictor of 1-year recurrence rate, irrespective of BRCA status.
- A negative HE4 value serves as a valuable predictor for 1-year recurrence-free survival in BRCA-mutated EOC.
- Biomarker normalization provides a robust tool for prognostic assessment in EOC.
