The discovery of a new immune-based biomarker could one day allow physicians to detect ovarian cancer up to four years earlier than conventional diagnostic methods.

Research published in Cell Reports Medicine found that in the early stages of high-grade ovarian cancer, a healthy immune system produces a measurable biomarker years before the tumour might otherwise be diagnosed. [1]

“Early detection of ovarian cancer could mean the difference between life and death for millions of women,” Bo Li, PhD, co-author of the study and a core faculty member in the Center for Computational and Genomic Medicine at Children’s Hospital of Philadelphia, said in a press release. [2]

“We believe our findings can be a game-changer, providing insights for developing an immune-based biomarker to detect early-stage ovarian cancers, as well as helping to potentially advance paediatric cancer research,” Li stated.

How T cells play a role

As part of their study, the researchers examined T cell receptors (TCRs)—proteins found in immune T cells—from nearly 500 blood samples from pre-diagnostic patients with ovarian cancer. They also examined blood samples from healthy/benign controls from the Nurses’ Health Study. [1]

“Together, our analyses support that ovarian tumour progression causes observable changes in the blood TCR repertoire, which are stronger at the early stage when HGOC is more likely to be curable,” the study authors write. [1]

According to the study, “[h]igh-grade ovarian cancer (HGOC) is a major cause of death in women. Early detection of HGOC usually leads to a cure, yet it remains a clinical challenge, with over 90% of HGOCs diagnosed at advanced stages. This is mainly because conventional biomarkers are not sensitive enough to detect the microscopic yet metastatic early lesions. Our findings may provide the basis for future immune-based HGOC early detection criteria.” [1] 

In the US, ovarian cancer is one of the leading causes of cancer deaths among women. [3]

The American Cancer Society estimates that roughly 19,680 women will receive a new diagnosis of ovarian cancer, and 12,740 will die from ovarian cancer in 2024.

If found early, roughly 94% of people with ovarian cancer live longer than five years after the time of diagnosis. [4] But only about 20% of ovarian cancers are diagnosed at an early stage.

“We have very few ways of detecting ovarian cancer. There are no screening tests. Pelvic ultrasounds and labs to check tumour markers are not diagnostic and, unfortunately, we subject women to surgery if and when they have suspicious ovarian masses. Having another tool to help us [determine] which tumours are more suspicious would be very helpful in detecting cancers at an early stage,” Diana Pearre, a board-certified gynecologic oncologist at the Roy and Patricia Disney Family Cancer Center at Providence Saint Joseph’s Medical Center in Burbank, CA, tells MDLinx.

She argues that ovarian cancer may be missed in the early stages for a variety of reasons.

Why is it so hard to catch?

“Generally, signs and symptoms may either not be there or maybe there but be so non-specific that they either get dismissed by physicians, not worked up properly, or even with appropriate diagnostic work-ups come up as negative or inconclusive. Because there is no screening test for ovarian cancer, it simply is not detected early enough in most cases. Where we have made advancements is for patients with hereditary breast and ovarian cancer syndromes. Offering risk-reducing surgery to those patients after childbearing or by a certain age has shown to significantly improve their survival, meaning they had a lower risk of dying from either breast or ovarian cancer,” Dr Pearre says.

The study authors say that further research is needed to develop a diagnostic test capable of detecting the newly discovered biomarker. They say that such a test would complement current approaches to detecting high-grade ovarian cancer. [2]

Until then, Dr. Pearre says, physicians must take the time to listen to their patients and take any concerns they may have seriously.

“Patients with ovarian cancer have suggested that listening to them and taking their concerns seriously would have, in their opinion, had their disease detected much earlier than it was. Although this may be secondary to recall bias, it may be true. I would also recommend patients have a meaningful discussion with their OB/GYNs about also removing their ovaries if they are having a hysterectomy—even for benign conditions when over a certain age (eg, 50). Hormone replacement therapy with estrogen therapy may mitigate the menopausal symptoms they may be experiencing already, and they can reduce their risk of ovarian cancer significantly,” she says.

Disclaimer: This story is contributed by Elizabeth Pratt and is a part of our Global Content Initiative, where we feature selected stories from our Global network which we believe would be most useful and informative to our doctor members.