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Diagnosis Of Ovarian Cancer: The Importance Of Biomarker

Your oncologist has many options for the course of ovarian cancer treatment. So how do they end up choosing which treatment plan to recommend? Physicians collect important information from indicators called biomarkers. Think of the biomarkers as certain characteristics each patient has that can help oncologists predict how they will respond to future treatment. Ultimately, biomarkers for ovarian cancer are one of the many factors that doctors use to guide treatment decisions. We talked with Dr. Douglas Levine, director of gynecological oncology at NYU's Perlmutter Cancer Center, to help us understand the role of biomarkers in making treatment decisions and predicting outcomes.

Success of the First Surgery

Dr. Levine says that the most important biomarker for success and treatment decisions is how it was the first surgical removal of the tumor. He says: "For advanced ovarian cancer, which is how most women have the disease, some people forget or ignore [that] the most important biomarker is your initial treatment …[including] surgical resection. "The goal of the initial surgery is to remove as much of the tumor as possible, Levine says. "The goal of surgery is to remove all the cancer that you can see with the naked eye, and this remains a very strong biological marker of overall survival," he explains. This is because women who have had a successful first surgery live significantly longer than those who do not have surgery.

Other biomarkers

According to Dr. Levine, in addition to the result of the initial treatment, the other biomarkers are:

  • It was – Levine says that this "is actually a complicated biomarker," largely because it usually contains two positive or favorable biomarkers in one. On the one hand, younger patients usually do better with treatment because they can tolerate treatment better. As Levine puts it, "They can tolerate all treatments without treatment intervals and with minimal toxicity." Second, younger women are also more likely to carry BRCA mutations, allowing them to respond better to treatments such as PARP inhibitors. In this sense, age is a double biomarker.
  • Performance status
  • Where you get treatment – The most important thing to note about the hospital where you receive treatment is how many patients with ovarian cancer they treat. High-volume cancer centers and surgeons who perform a high volume of surgeries have proven to perform better than those with fewer surgeries or patients. As Dr. Levine explains, "Several studies have shown that if you go to a high volume center, a center that treats a lot of ovarian cancer, its results are dramatically better. So it's the center and the surgeon because surgeons who do this often and centers that treat ovarian cancer often have processes to incorporate all the latest treatments and give the best results in the safest possible way. "
  • Tumor genetics – In particular, BRCA mutations are the most important genetic biomarker for ovarian cancer. It contributes to the early development of ovarian cancer in younger women, but if you have the disease, that mutation will allow you to respond better to certain treatments, such as PARP inhibitors.
  • CA-125- This is a protein that may be present in the blood and is "one of the best biomarkers for monitoring ovarian cancer treatments," Levine says. By tracking levels of CA-125 in the blood, oncologists can determine if the cancer has returned after initial treatment. Although the use as a way to initially detect cancer is limited, it is the most important biomarker for post-treatment monitoring.

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Dr. Douglas Levine is a gynecologic oncologist at NYU Langone Health. see More Information

Your oncologist has many options for the course of ovarian cancer treatment. So how do they end up choosing which treatment plan to recommend? Doctors collect key information from indicators called …