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. 2024 May 28:14:1399502.
doi: 10.3389/fonc.2024.1399502. eCollection 2024.

Clinical value of serum tumor markers in assessing the efficacy of neoadjuvant chemotherapy in advanced ovarian cancer: single-center prospective clinical study

Jing Huang #  1 , Danyi Du #  2 , Hailong Chen #  1 , Deping Luo  1 , Qi Wang  1 , Chan Li  1 , Yuanxiang Li  3 , Ying Yu  1
Affiliations

Clinical value of serum tumor markers in assessing the efficacy of neoadjuvant chemotherapy in advanced ovarian cancer: single-center prospective clinical study

Jing Huang et al. Front Oncol. .

Abstract

Objective: This study aimed to assess the clinical importance of various biomarkers, including NLR, CEA, CA199, CA125, CA153, and HE4, through dynamic testing to evaluate the effectiveness of neoadjuvant chemotherapy (NACT) for individuals facing advanced ovarian cancer. This provides valuable information for tailoring treatment plans to individual patients, thereby leading to a more personalized and effective management of individuals facing ovarian cancer.

Methods: The levels of NLR, CA125, CA199, CEA, CA153, and HE4 were detected before chemotherapy and after 3 courses of chemotherapy. Patients were categorized into ineffective and effective groups according to the effectiveness of NACT. To evaluate the factors influencing NACT's effectiveness in individuals facing advanced ovarian cancer, receiver operating characteristic (ROC) curves, predictive modeling, and multifactorial regression analysis were employed.

Results: In the effective group, the patients' age, maximum tumor diameter, and CEA and HE4 levels of the patients were significantly higher compared to those in the ineffective group (P <.05). Additionally, the difference in HE4 levels before and after treatment between the effective and ineffective groups was statistically significant (P<.05). Multifactorial analysis showed that age and maximum tumor diameter were independent risk factors impacting the effectiveness of NACT in individuals facing advanced ovarian cancer (P<.05). The ROC curve for predicting the effectiveness of NACT in individuals facing advanced ovarian cancer showed a sensitivity of 93.3% for NLR and a specificity of 92.3% for CA199. HE4 emerged as the most reliable predictor, demonstrating a specificity of 84.6% and a sensitivity of 75.3%. The area under the curve of the combined CA125 and HE4 assays for predicting the ineffectiveness of NACT in individuals facing advanced ovarian cancer was 0.825, showcasing a specificity of 74.2% and a sensitivity of 84.6%.

Conclusion: The predictive capacity for the effectiveness of NACT in individuals facing advanced ovarian cancer is notably high when considering the sensitivity of NLR and the specificity of CA199. Additionally, the combination of CA125 and HE4 assays can obtain a better predictive effect, which can accurately select patients suitable for NACT, determine the appropriate timing of the interval debulking surgery (IDS) surgery, and achieve a satisfactory tumor reduction effect.

Keywords: efficacy of chemotherapy; human epididymal protein 4; neoadjuvant chemotherapy; ovarian cancer; predictive indicators.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Neoadjuvant chemotherapy for advanced ovarian cancer predictive column line chart.
Figure 2
Figure 2
Training set calibration analysis.
Figure 3
Figure 3
Validation set calibration analysis.
Figure 4
Figure 4
Validation set: decision curve analysis curve.
Figure 5
Figure 5
Training set: decision curve analysis curve.
Figure 6
Figure 6
Receiver operating characteristic curves of predictive models in training and validation sets.
Figure 7
Figure 7
Receiver operating characteristic curves for each test to predict. efficacy of neoadjuvant chemotherapy in patients with ovarian cancer.
Figure 8
Figure 8
Predictive value of combined assays for the efficacy of neoadjuvant chemotherapy in patients with advanced ovarian cancer.
See this image and copyright information in PMC

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