Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy; it primarily affects postmenopausal women, and the average age of onset is between 55 and 65 years in the USA. The prevalence is one in 2,500 postmenopausal women.
We don´t have ideal strategies for prevention and detection, and 80% of cases are locally advanced disease. A variety of biomarkers have been developed to monitor growth. CA-125 (MUC 16) has provided a useful serum tumor marker for monitoring the efficacy of cytotoxic chemotherapy and the early detection of relapse during the follow-up of patients.
Twenty per cent of all cases have little or no expression of CA-125 and it is necessary to explore new markers for early disease or screening. Several algorithms have been developed that calculate the risk of ovarian cancer on serial CA-125 values and refer patients at highest risk for transvaginal sonography, but the strategy is limited.
More than 30 serum markers have been evaluated alone and in combination with CA-125 by different investigators. Some of the most promising include: HE4, mesothelin, M-CSF, osteopontin, kallikreins, and the soluble growth factor receptor.
In this review, we describe the actual status of CA-125, new strategies for early detection, and the utility of the new markers in this disease.