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This is a Cross-Sectional Study study.

September 19, 2025Open Access

Utility of Serum HE4 and CA-125 in Monitoring Chemotherapy Response During Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Carcinoma

Key Points

HE4 level significantly decreased in patients responding to neoadjuvant chemotherapy, suggesting its utility in monitoring efficacy.
CA-125 did not show a statistically significant association with response category after neoadjuvant chemotherapy.
Cross-sectional comparative study was conducted to evaluate serum biomarkers in advanced epithelial ovarian carcinoma.
Further research is necessary to determine the long-term implications of HE4 and CA-125 on patient outcomes.

Abstract

Background: In recent years the most fatal gynecological cancer is ovarian cancer (OC) and it is the eighth leading cause of cancer death in women. Neoadjuvant Chemotherapy (NACT) subsequently interval debulking surgery (IDS) is a substitute treatment approach in advanced epithelial ovarian cancer. Relapse associated with chemoresistance is shown in fifty to seventy percent of treated patients, which is one of the foremost challenges to deal with in ovarian cancer research. Objectives: This survey was driven to evaluate the effectiveness of serum HE4 and CA-125 in monitoring the response of chemotherapy in advanced epithelial ovarian cancer who are selected for Neoadjuvant Chemotherapy (NACT). Methods: This cross-sectional comparative study was conducted from January 2022 to December 2022 at the National Institute of Cancer Research and Hospital to find out the association of serum levels of HE4 and CA125 with the clinical and tomographic response after neoadjuvant chemotherapy in advanced ovarian carcinoma. Results: Principal number of respondents were from the 41-50 years age group. The mean age of the patients were 52.27 (SD: ±10.55) years. In this current study association between response category and HE4 level after NACT is examined. The mean value of HE4 after NACT in no-response group was 539.03 whereas in response group this value decreased to 140.58. On independent t-test this difference was statistically significant (p=0.027). However, association between response category and CA-125 level after NACT was not statistically significant (p>0.05). Conclusion: HE4 and CA-125 biomarkers can be effectively used to monitor the response of chemotherapy in advanced epithelial ovarian cancer who are selected for NACT, further study is needed to understand the impact of the biomarkers in terms of successful cytoreduction, in predicting platinum sensitivity, disease-free survival, risk to progress and overall survival. CME J 2025; 4(2):49-61

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