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World J Biol Chem. Aug 26, 2014; 5(3): 286-300
Published online Aug 26, 2014. doi: 10.4331/wjbc.v5.i3.286
In 2014, can we do better than CA125 in the early detection of ovarian cancer?
Joshua G Cohen, Matthew White, Ana Cruz, Robin Farias-Eisner
Joshua G Cohen, Matthew White, Ana Cruz, Robin Farias-Eisner, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California, Los Angeles Medical Center, Los Angeles, CA 90095, United States
Author contributions: Cohen JG, White M and Cruz A performed research and acquisition of data; Cohen JG, White M, Cruz A and Farias-Eisner R performed synthesis of data, developed tables and figures, and authored manuscript.
Correspondence to: Robin Farias-Eisner MD, PhD, Department of Obstetrics and Gynecology, University of California, Los Angeles Medical Center, Peter Morton Medical Building, 200 Medical Plaza, Suite 220, Los Angeles, CA 90095, United States. rfeisner@mednet.ucla.edu
Telephone: +1-310-2068914 Fax: +1-310-2062057
Received: January 17, 2014
Revised: March 12, 2014
Accepted: May 14, 2014
Published online: August 26, 2014
Processing time: 236 Days and 18.8 Hours
Abstract

Ovarian cancer is a lethal gynecologic malignancy with greater than 70% of women presenting with advanced stage disease. Despite new treatments, long term outcomes have not significantly changed in the past 30 years with the five-year overall survival remaining between 20% and 40% for stage III and IV disease. In contrast patients with stage I disease have a greater than 90% five-year overall survival. Detection of ovarian cancer at an early stage would likely have significant impact on mortality rate. Screening biomarkers discovered at the bench have not translated to success in clinical trials. Existing screening modalities have not demonstrated survival benefit in completed prospective trials. Advances in high throughput screening are making it possible to evaluate the development of ovarian cancer in ways never before imagined. Data in the form of human “-omes” including the proteome, genome, metabolome, and transcriptome are now available in various packaged forms. With the correct pooling of resources including prospective collection of patient specimens, integration of high throughput screening, and use of molecular heterogeneity in biomarker discovery, we are poised to make progress in ovarian cancer screening. This review will summarize current biomarkers, imaging, and multimodality screening strategies in the context of emerging technologies.

Keywords: Ovarian cancer; Screening; Biomarker; Detection; Diagnostic imaging; Proteomics; Adnexal mass

Core tip: Ovarian cancer is a lethal gynecologic malignancy with five-year survival of only 20% to 40% for advanced stage disease. Detection at an early stage would likely have significant impact on mortality rate. Advances in high throughput screening with the human “-omes” including the proteome, genome, metabolome, and transcriptome are now available in various packaged forms. To make progress in screening we need greater emphasis on prospective collection of patient specimens, integration of high throughput screening, and use of molecular heterogeneity in biomarker discovery.