Researchers from the Children’s Hospital of Philadelphia (CHOP) have uncovered a biomarker that can be detected in the blood up to four years before high-grade ovarian cancer (HGOC) is typically diagnosed. This discovery can potentially be a “game-changer” in early detection of ovarian cancer and could advance pediatric cancer research as well.
Overview of Ovarian Cancer in the US
Ovarian cancer is a leading cause of cancer death among women in the US. While there has been a decrease in the number of cases over the past few decades, thousands of women are still affected by it.
According to the American Cancer Society (ACS), between 1990 and 2014, the incidence of ovarian cancer diagnoses declined by 1%-2% each year. Between 2015 and 2019, it declined by 3% each year. Researchers attribute the declining number of cases to the increasing use of oral contraceptives and a decreasing use of menopausal hormone therapy.
However, even with encouraging numbers, in 2024 women still have a 1 in 87 risk of getting ovarian cancer and a 1 in 130 risk of dying from it. This year alone, ACS anticipates that 19,680 women will be diagnosed with ovarian cancer and 12,740 will die from it.
If detected early, approximately 94% of women with ovarian cancer will go on to live at least five years more since their initial diagnosis. However, at this point, only 20% of cases are diagnosed at an early stage. The main reason for this is that there are no successful diagnostic screening tests for ovarian cancer.
The current available tests are:
- TVUS (transvaginal ultrasound), a test that uses sound waves to check the female anatomy for tumors. While this test can find masses, it can’t tell whether they are cancerous or benign.
- The CA-125 blood test, which measures the amount of protein CA-125 in the blood (as many women with ovarian cancer have high levels of this protein). This test is more useful for women who have already been diagnosed with ovarian cancer, to see if the treatment is working. However, it’s not actually effective as a screening test. (High levels of CA-125 can also be caused by other conditions, including endometriosis and pelvic inflammatory disease, while not all women with ovarian cancer have high CA-125 levels).
- Pelvic exam, when a healthcare professional physically feels the areas of a woman’s ovaries and uterus, is not likely to detect cancer at an early stage.
- Screening tests used for cervical cancer, such as a Pap test or HPV (human papillomavirus) test, typically effective at screening for cervical cancer, aren’t effective for ovarian cancer. In rare cases, ovarian cancers can be found through Pap tests, but at this point the cancer has reached an advanced stage.
Because the current screening tests are woefully inaccurate, the discovery of a biomarker that can potentially detect HCOG up to four years before typical diagnosis is extremely significant.
CHOP Researchers Discover: The Immune-Based Biomarker
Early detection of HGOC typically leads to a cure but more than 90% of cases are diagnosed at advanced stages. Early detection procedures are ineffective because conventional biomarkers aren’t sensitive enough to detect early metastatic lesions.
In the current study, CHOP researchers examined T cell receptions (TCRs), proteins found in immune T cells, from about 500 blood samples from pre-diagnostic patients with ovarian cancer. They also analyzed blood samples from healthy/benign controls. They found that a healthier immune system has a stronger reaction in the early stages of high-grade ovarian cancer, creating a measurable biomarker. This biomarker may be able to be used for immune-based detection of ovarian cancer two to four years before most cases are currently diagnosed.
Working Together with Healthcare Providers
While initial results are promising, CHOP researchers noted that additional research is necessary to further develop diagnostic testing sensitive enough to detect HGOC in its early stages. They envision such a test as a complement to other HGOC screening protocols that are currently approved.
As research is ongoing, healthcare providers should do everything in their power to make early detection possible. Listening to patients’ symptoms and getting a thorough family medical history can help physicians spot warning signs of HGOC and launch early intervention treatments.
At the same time, every woman must be her own advocate and arm herself with knowledge so she can be aware of the warning symptoms. Regular health exams, especially pelvic exams, are extremely important for women (these may not reveal ovarian cancer but can uncover other conditions). When ovarian cancer is found too late, it’s usually untreatable. But when detected early, the odds of successful treatment greatly increase.