The fact that survival is associated with the stage at time of diagnosis of ovarian cancer, and that around 60% of these cancers are diagnosed in advanced stages, makes all efforts to improve diagnosis justified.
The Scientific Committee of the Spanish Society of Laboratory Medicine (SEQCML), as it does every year, held its traditional meeting, the XVIII Conference of the Scientific Committee, which addressed and updated various important aspects in the clinical laboratory field. This year’s meeting took place in virtual format.
"The Scientific Committee Conferences are one of the most important activities in which the Society's commissions participate and one of its main objectives," says Dr Eva Guillén Campuzano, president of the Scientific Committee of the SEQCML.
As this expert notes, “the format of the courses and the combination of the topics covered in each lead to them being very well received, among both experienced professionals and residents, allowing them to update their scientific knowledge of the topics covered”. These courses –adds Dr Guillén- combine new topics or those of greater current interest with more academic topics, condensing the most important aspects related to the topic at hand. "The distribution and duration of the talks allows the speakers to adequately transmit the content, leaving a space for the attendees’ participation, which is always very attractive and interesting," she points out.
Ovarian cancer is the ninth most frequent type of tumour in women, but the fourth in terms of mortality, which makes it a health problem. The fact that survival is associated with the stage at time of diagnosis, and that around 60% of ovarian cancers are diagnosed in advanced stages, makes all efforts to improve diagnosis justified.
Specifically, in cases that are diagnosed in stages III or IV, the 5-year survival varies between 11 and 37%, while in those that are diagnosed in stage I or II, it increases up to 93%. “In other words, we are facing a tumour in which early diagnosis is essential, both in terms of survival as well as in terms of morbidity for the patient and costs for the health system. In this sense, the laboratory has a lot to contribute”, points out Dr Antonio Barco, member of the Commission on Biological Markers of Cancer of the Spanish Society of Laboratory Medicine (SEQCML).
For this reason, within the framework of the Scientific Committee of the SEQCML Conference, the role of the laboratory in ovarian cancer was addressed: prevention, diagnosis, prognosis, treatment, and follow-up.
“Today, the laboratory has taken a very important step forward and we not only develop algorithms that contextualize the clinical use of tumour markers, but we also combine them with imaging techniques and patient clinical data to the point of improving significantly the sensitivity, specificity, and predictive values, and being able to make earlier diagnoses. This also allows for optimizing the use of health system resources, in secondary diagnostic tests, or referral of patients to the high- or low-complexity operating room as appropriate ", emphasized Dr Barco, moderator of the panel.
In addition, he points out that the laboratory is currently preparing increasingly accurate interpretative reports and actively participating in hospital clinical committees, and notes that "it must also participate in the elaboration of patient care protocols for the various kinds of tumours."
Advances in diagnosis
The SEQCML Commission on Biological Markers of Cancer is currently following several lines of research, initiated by Dr Rafael Molina, in the field of diagnosis. Specifically, a multicentre study has been completed in 10 Spanish hospitals for the validation of a lung cancer diagnostic algorithm that will be published soon, and similar work is being done for the validation of a diagnostic model for ovarian cancer, with which very good results are being obtained, in many cases detecting stage I tumours, including borderline tumours (tumours with low potential for malignancy). "In addition, we are able to avoid many false positives that occur when using other algorithms that use imaging techniques, which means we can avoid unnecessary laparotomies, reducing morbidity for patients and improving the efficiency of health resources," says Dr Barco.
Likewise, several members of the SEQCML Commission on Biological Markers of Cancer have developed a tool to make these algorithms available to the various laboratories, so as to facilitate the homogenization of the results, the validation of the models in multicentre studies, and their continuous improvement.
Proper management of tumour markers
As he explains, proper management of the levels of the various tumour markers, taking into account the coefficients of variation, etc., makes it possible to detect tumour recurrences 1-15 months earlier than imaging tests (with a median of 3-4 months). In addition, assessing the levels of these markers at different times during treatment makes it easier to detect patients with a worse therapeutic response, which makes it possible to carry out earlier therapeutic modifications, saving time and resources and reducing morbidity.
In all this process, the clinical laboratory professional plays a fundamental role. "The laboratory is at a time when it is in a position to take a step forward to increase the added value it can provide in the management of cancer pathology," says Dr Barco. To this end, the SEQCML Commission on Biological Markers for Cancer is collaborating with other medical societies such as the SEOM (Spanish Society of Medical Oncology) to participate in the development of clinical guidelines for various tumours.