Non-Genomic Biomarkers of Risk in Ovarian Cancer

Cancer biomarkers are biologic substances able to measure molecular, cellular, tissue, or host factors associated with cancer susceptibility, pathogenesis, response to treatment, or survival. Most familiar are serum biomarkers associated with cancer progression like the classic tumor markers, CEA, CA 125, CA 15.3, or PSA. Their use has been extended to early detection as well as surrogate endpoints in prevention or treatment trials. Many “classic” biomarkers are secreted by cancer cells or are direct consequences of the tumor diathesis; and their levels closely correlate with tumor burden. However, other biomarkers may not depend upon a cancer being present. Rather, they may reflect risk for or susceptibility to cancer. There are several reasons why susceptibility or risk biomarkers might represent an attractive strategy to reduce the morbidity and mortality of ovarian cancer. Risk biomarkers might point to options for chemoprevention; e.g. raising levels of a nutrient that appears to be deficient. Even if the risk biomarker suggests no obvious prevention strategy, women identified to be at very high levels of risk for ovarian cancer could be offered prophylactic surgery. Primary prevention of ovarian cancer through removal ovaries and tubes in high-