A new study of OVA1® clinical performance, titled “The Effect of Ovarian Imaging on the Clinical Interpretation of a Multivariate Index Assay,” has been released as an online advance publication of The American Journal of Obstetrics & Gynecology.[i] The study examines the relationship between two commonly used imaging methods – ultrasound (US) and computed tomography (CT) – and the OVA1 test result, in assessing the risk of ovarian cancer among patients planning surgery for an ovarian mass. OVA1 is an FDA-cleared blood test that measures the levels of five proteins and then uses a proprietary algorithm and software called OvaCalc® to calculate a single risk score.
“This new study advances our understanding of how OVA1 and imaging work together in the pre-surgical assessment of ovarian cancer risk,” said study co-author Fred Ueland, M.D., associate professor of gynecologic oncology at the University of Kentucky’s Markey Cancer Center. “This is important for two reasons. First, adding OVA1 reduced the number of ovarian cancers missed with imaging alone, by 85 to 90 percent. Recent publications have reinforced that the first surgery is an important opportunity to improve ovarian cancer survival by ensuring that cancers are detected earlier and that they are operated on by the most experienced specialists. Second, this study provides new evidence of how menopausal status, imaging and OVA1 score may interrelate.”
Dr. Scott Goodrich of the University of Kentucky led the study in collaboration with colleagues Drs. Fred Ueland and Rachel Ware Miller. The findings are the third in a series of subset analyses of data obtained from 1,100 ovarian mass surgery patients in two previous pivotal trials of OVA1 clinical performance, conducted in 2007 and 2012. The authors compared the performance of each imaging method alone, to the performance of OVA1 alone (for risk stratification), as well as in combination with OVA1. In addition, the authors presented logistic regression models showing how menopausal status, high- or low-risk imaging and OVA1 score interact in the assessment of ovarian cancer risk. The researchers concluded that “serum biomarkers and imaging are a complementary set of clinical tools and that when the [OVA1] score is further stratified by imaging risk and menopausal status, there is a better understanding of the clinical risk of ovarian malignancy.”
This latest study brings the number of full research articles on OVA1 clinical performance to a total of five peer-reviewed publications. Together, these data provide strong, prospective clinical evidence that OVA1 improves the pre-surgical detection of ovarian cancer, regardless of stage or subtype, in patients undergoing surgery for a suspicious ovarian mass.
“The sensitivity of OVA1 is critical to the detection of ovarian malignancy, pre-surgical risk assessment and determining whether a woman may benefit from consultation with a gynecologic oncologist prior to surgery,” said Donald Munroe, chief scientific officer and SVP of business development at Vermillion. “Vermillion is committed to fully developing this clinical evidence, together with future studies on how OVA1 may impact the efficiency and quality of care for women facing ovarian cancer, the deadliest of all gynecologic malignancies.”
More than 22,000 women are diagnosed with ovarian cancer in the United States annually, and more than 12,000 die each year.[ii] Leading medical associations, including the American College of Obstetrics and Gynecology (ACOG), recommend that women with suspected ovarian cancer be referred to a gynecologic oncologist for surgery for the best potential outcomes. However, only an estimated one-third of women who have a malignant tumor are operated on by a gynecologic oncologist for the initial removal of cancer.[iii]
[i] The Effect of Ovarian Imaging on the Clinical Interpretation of a Multivariate Index Assay, Scott T. Goodrich, MD, Robert E. Bristow, MD, MBA, Joseph T. Santoso, MD, Rachel W. Miller, MD, Alan Smith, Zhen Zhang, PhD, Frederick R. Ueland, MD, American Journal of Obstetrics & Gynecology, doi:10.1016/j.ajog.2014.02.010, published online 14 February 2014.
[ii] National Cancer Institute. Seer Stat Fact Sheets – Ovarian Cancer. http://seer.cancer.gov/statfacts/html/ovary.html.
[iii] Earle CC, Schrag D, Neville BA, et al. Effect of Surgeon Specialty on Process of Cancer Care and Outcomes for Ovarian Cancer Patients. J Natl Cancer Inst (2006) doi: 10.1093/jnci/djj019.