[read time: 4 min approx.]
Ovarian cancer is the most lethal reproductive cancer with over 70% of cases diagnosed in advanced stages, when treatments are not effective. Diagnosis at an earlier stage could increase survivability from 49% to above 90%. This could be achieved by improving the current diagnosis procedures, and developing an ovarian cancer screening test for early detection. There are currently no approved ovarian cancer diagnostic tests because none of the current tests are specific to ovarian cancer. Patients presenting with symptoms are assessed for ovarian cancer risk using non-specific tests (ultrasound and CA125 antigen test) to determine if surgery is required. Hence, there is an urgent need to develop ovarian cancer specific tests for diagnosis and for early detection.
Promising findings from an Ovarian Cancer Research Foundation (OCRF) grant, awarded to Associate Professor Michelle Hill’s team at QIMR Berghofer Institute of Medical Research, were recently published. Associate Professor Hill discusses the research.
What did the study find?
Biomarkers are measures within the body used to indicate change, such as blood pressure or blood glucose measurements. Biomarkers help with diagnosis (determining if disease is present), and early detection (prior to symptoms).
Diagnosis: The research discovered four blood biomarker signatures with potential to distinguish accurately between ovarian cancer and non-cancerous, benign ovarian tumours, and healthy samples. The most accurate achieved 90.7% specificity and 70.4% sensitivity.
Early Detection: Three of the biomarkers show change, on average 11 months earlier to current diagnostic procedures, in asymptomatic women.
This indicates that using these biomarkers could enable ovarian cancer detection almost a year earlier than is currently possible.

How did the study work?
Often biomarker research focuses on molecules that are released directly from the tumour, but these signals can be tiny or non-existent at the earliest stages of cancer. Associate Professor Hill’s technique measured blood glycoproteins as biomarkers—proteins with sugars attached. Previous research found general changes in sugars on blood proteins during cancer development. Therefore, the team hypothesized that these sugar changes reflect the body’s response to the developing tumour and could be used in early detection.
Step 1: The team compared serum samples from participants of a similar age. Three groups of patient samples were compared, high-grade serous ovarian cancer (the most common type), benign ovarian tumours (non-cancer tumours), and healthy women. Two samples sets were used in this step, one collected at diagnosis, the other collected 4-18 months prior to diagnosis — samples from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) study, which tracked participants for over a decade.
Step 2: Glycoproteins that presented differently between sample groups in the first step were retested in a second sample set. This evaluated the accuracy of the blood biomarkers to diagnose ovarian cancer from non-cancer and healthy women.
Step 3: They examined the biomarkers levels in the initial UKCTOCS study to determine at what point before diagnosis the newly identified biomarkers first altered. In total Associate Professor Hill’s study analysed 158 samples.
Associate Professor Hill
what's next?
To develop these biomarkers into clinical tests, Associate Professor Hill plans to establish a new startup company. Funding will be sought to develop a prototype test, which requires a larger study with approximately 600 samples to establish the final biomarker signatures.
Once prototype tests have been developed, a diagnostic clinical trial will be conducted to obtain data for regulatory approval. This trial may take three years, with potential regulatory approval in five years. To demonstrate efficacy for early detection, a large group of healthy women will need to be screened and tracked for over a decade.
With 22 years of experience as a researcher and 13 years as research group leader, Associate Professor Hill understands the difficulties researchers experience in propelling their work forward.
“Being a researcher means working contract to contract, continuously applying for grants to continue the work. It can be stressful, and the pandemic has created an even more volatile situation for researchers. That’s why discoveries like this, that show the promise of perseverance, are so exciting. It shows hard work isn’t in vain and there’s hope for an early detection test for future generations. But only if ovarian cancer research continues to be funded”.
If we don't fund researchers, we'll lose them
Ovarian cancer is the most lethal reproductive cancer and remains chronically underfunded. This is why the OCRF is thrilled to share such promising early-stage findings. We continue to support the sector by providing researchers with much needed funding and by advocating to government so that promising research like Associate Professor Hill’s can be reach its potential.
Research breakthroughs take time and sustained funding.
Yet the lives saved now and into the future are priceless.
Support research breakthroughs by becoming a regular donor.
Read more: Associate Professor Hill presented at the Early-Stage Innovation Forum recently held in Adelaide and was a winning speaker.
This article has been reviewed and approved by Associate Professor Michelle Hill.