Malignant Tumor or Benign Cyst?: Researcher from Women & Infants´/Alpert Medical School Says Combination Tests Could Identify Women´s Ovarian Cancer Risk for More Accurate Diagnosis, Treatment



    The results of a study presented today at the Society of
    Gynecologic Oncology´s 39th Annual Meeting on Women´s Cancer offer a
    promising development on the path toward better management of ovarian
    cancer. Researchers say testing women suspected of having ovarian
    cancer for a combination of proteins, or biomarkers in the blood
    called HE4 and CA 125, could be the key to predicting a woman´s risk
    for the disease dubbed the "silent killer." Currently there is no
    adequate diagnostic test for ovarian cancer.

    "Roughly 20 percent of women will be diagnosed with an ovarian
    cyst or tumor at some point in their life, and only a small percentage
    of these women will be diagnosed with ovarian cancer," said Lead
    Researcher Richard Moore, M.D., assistant professor at The Warren
    Alpert Medical School of Brown University and a gynecologic oncologist
    in the Program in Women´s Oncology at Women & Infants´ Hospital of
    Rhode Island. "The problem is that current methods for distinguishing
    benign ovarian tumors from malignant ones are limited and as a result,
    women must undergo surgery without an accurate assessment as to their
    risk for having ovarian cancer prior to their surgery."

    Dr. Moore notes that fewer than half of all ovarian cancer
    patients have their initial surgery performed by a gynecologic
    oncologist or surgeon with specialized training in the management of
    ovarian cancer. "Our research is aimed at identifying patients at high
    risk for harboring an ovarian cancer so that they receive the right
    care from the right physician."

    Currently, CA 125 is the only blood test that can be used to help
    predict a woman´s risk for ovarian cancer and to help with the
    clinical management of the disease. However, CA 125 alone lacks the
    sensitivity required for the detection of ovarian cancer prompting
    researchers to look at the ability of combinations of biomarkers to
    predict the presence of ovarian cancer. Earlier this year, Dr. Moore
    published results of a pilot study in the journal of Gynecologic
    Oncology evaluating nine potential biomarkers and the ability of
    multiple marker combinations to predict the risk for ovarian cancer in
    women. His findings showed the combination of HE4 and CA 125 provided
    the highest level sensitivity and specificity out of all marker
    combinations for predicting the presence of ovarian cancer.

    In a prospective, double-blinded, multicenter clinical trial, Dr.
    Moore and his team studied 496 women presenting with pelvic mass or
    ovarian cysts to determine if tests targeting multiple markers
    utilizing HE4 and CA 125 and a predictive algorithm could accurately
    assess the risk for epithelial ovarian cancer prior to surgery.
    Researchers measured levels of the biomarkers within the women´s blood
    and then compared the results with biopsies of their tumors. The
    combination of biomarkers performed well in both pre- and
    post-menopausal women, accurately stratifying 95 percent of patients
    with epithelial cancer as high risk and 75 percent of benign cases as
    low risk.

    "Studies suggest women with ovarian cancer have better outcomes
    and increased survival when treated by surgeons trained in the
    management of ovarian cancer and at institutions specializing in the
    care of women with this disease," adds Dr. Moore. "By using the
    combination of HE4 and CA 125 as a model to assess a women´s risk for
    ovarian cancer, physicians can better triage patients for care and
    refer them to the appropriate specialist - whether at a community
    hospital or large academic institution."

    "Together, HE4 and CA 125 offer a powerful combination that could
    dramatically change the way ovarian cancer is managed at all stages of
    care," said Dr. Olle Nilsson, vice president and chief scientific
    officer of Fujirebio Diagnostics, the developers of the CA 125 test.
    "As research continues to progress, it is our hope that a test for HE4
    and CA 125 could eventually lead to a plausible screening tool."

    Fujirebio Diagnostics has developed a manual test for HE4 and will
    be developing automated formats of the test for Fujirebio instruments.
    The HE4 test is CE marked in Europe. The company has applied to the
    U.S. Food and Drug Administration (FDA) and hopes to see availability
    of the test in late 2008.

    About Fujirebio Diagnostics, Inc.

    Fujirebio Diagnostics, Inc. is a premier diagnostics company and
    the industry leader in biomarker assays. Fujirebio Diagnostics
    specializes in the clinical development, manufacturing and
    commercialization of in-vitro diagnostic products for the management
    of human disease states, with an emphasis in oncology. Fujirebio
    Diagnostics is one of the group companies of Miraca Holdings Inc. in
    Japan, set up in July 2005 to combine Fujirebio Inc., the leading
    in-vitro diagnostics company, and SRL, Inc., the top provider of
    clinical laboratory testing services in Japan. Fujirebio Diagnostics
    has a worldwide distribution network, which enables physicians and
    patients to access its diagnostic products. For more information about
    Fujirebio Diagnostics, please call 610-240-3800 or visit www.fdi.com.

    About Women & Infants Hospital

    Women & Infants Hospital of Rhode Island, a Care New England
    hospital, is one of the nation´s leading specialty hospitals for women
    and newborns. The primary teaching affiliate of The Warren Alpert
    Medical School of Brown University for obstetrics, gynecology and
    newborn pediatrics, Women & Infants is the ninth largest obstetrical
    service in the country with more than 9,000 deliveries per year. In
    2003, Brown University and Women & Infants were named a National
    Center of Excellence in Women´s Health by the U.S. Department of
    Health and Human Services. Women & Infants has been named one of the
    best hospitals in gynecology in the 2000, 2001 and 2004 editions of
    America´s Best Hospitals in U.S. News & World Report. For information
    about Women & Infants, log on to www.womenandinfants.org.