RSS Feeds
Update in Oncology
- Steven H. Stein, MD
- From the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
2003-2004 Series: Update Sessions from ACP's 2003 Annual Session
This year's Update in oncology discusses 7 manuscripts published in 2002. Each provides evidence that could change standards of care. The articles fall into the following categories: screening, prevention, and therapeutics. I compiled these articles with the help of my colleagues at the University of Pennsylvania Cancer Center, Philadelphia, Pennsylvania.
Screening
Perhaps the most exciting news came from the field of proteomics. A new study indicated that proteomics pattern technology may become a valuable tool for screening for early ovarian cancer.
Proteomics Tool Identified Early Ovarian Cancer
Ovarian cancer presents at a late clinical stage in more than 80% of patients, and 5-year survival rates range from 30% to 35%. In comparison, early, stage I ovarian cancer has a 5-year survival rate greater than 90%, and surgery alone suffices to cure most patients. Currently, CA 125 screening is used to identify ovarian cancer, but levels are elevated in only approximately half of patients with stage I disease. Therefore, only 10% of women with a positive test result have ovarian cancer, a figure that increases to 20% if CA 125 is coupled with transvaginal ultrasonography. The low sensitivity means that screening misses many cases of early-stage ovarian cancer.
Petricoin and colleagues tested the hypothesis that the profile of a group of low-molecular-weight proteins in serum can reveal the pathologic state of organs and thereby detect cancer. The investigators used mass spectrometry tools to profile the proteins in a small serum sample. To analyze the resulting data, they created an algorithm based on a serum analysis of 50 unaffected women and 50 women with ovarian cancer. They found a proteomic pattern that completely discriminated cancerous ovaries from noncancerous ovaries. The algorithm was then incorporated into computer software to identify protein patterns that indicated cancer in individual women.
The investigators tested …
