Development of improved pre-diagnostic biomarker-based screening algorithms for ovarian cancer
We have interrogated the pre-diagnostic PLCO samples with assays for several promising candidate biomarkers and have developed two multimarker algorithms. The first algorithm was comprised of FSH/HE4/TTR/ADAMTS13 and offered 71%SN at 95%SP in HGSC samples collected 0.5-1.5 YTD. The second algorithm consisted of HE4/FBG/PF4/APOA1 with 62%SN at 95%SP for OC samples collected 18-84 MTD. Both multimarker algorithms offered clear advantage to CA125 and HE4. However, the SN needs to be further improved.
We have demonstrated that tumor-associated auto-autoantibodies (AAb) against TRIM21, NYESO1, and TP53 can predict recurrence in platinum-sensitive OC patients before CA125 rise. We have additionally developed a unique methodology for analysis of circulating AAbs with high analytical SN.
Our goal is to improve SN of our two multimarker algorithms for both 0.5-1.5 and 1.5-7 YTD intervals. We hypothesize that combining our multimarker algorithms with AAbs and covariate data collected by PLCO in pre-diagnostic PLCO samples could improve the SN by 5-10% making them clinically useful for OC screening.
We utilize a Curiox modification of Luminex method that allows to use 5-fold less sample volume. In our case, analysis of FSH, HE4, FBG, PF4, TTR, APOA1, ADAMTS13, and AAbs in a multiplex format will require <25 microL of serum for all biomarkers.
Specific aims are: (1) To obtain serum samples and covariate data on incident HGSC PLCO cases collected 6-84 MTD and 1:2 non cancer controls (matched by age and date of study entry); (2) Test the performance of FSH, HE4, TTR, ADAMTS13, FBG, PF4, APOA1, and AAbs to NYESO1, TP53, TRIM21, and IL8 in these cases in comparison with non-cancer controls; (3) Develop new improved algorithms for screening in 6-18 and 18-84 MTD subsets.
Anna Lokshin (UPMC Hillman Cancer Center)
Lynnette Smith (University of Nebraska)
Jian Min Yuan (University of Pittsburgh)
Robert Bast (MD Anderson Cancer Center)
Michael Tainsky (Wayne State University)