Discriminating Borderline From Stage I Invasive Ovarian Cancer (BIOC): a Prospective Multicenter Diagnostic Biomarker Study

The BIOC study, titled Discriminating Borderline from Stage I Invasive Ovarian Cancer, is a prospective, multicenter diagnostic biomarker study designed to refine diagnostic accuracy for ovarian cancer, specifically to differentiate between borderline ovarian tumors (BOT) and stage I invasive ovarian cancer. Existing diagnostic tools, such as the CA125 biomarker, are limited in their ability to provide precise differentiation in early stages, which is crucial for appropriate pre-surgical treatment planning. This study builds upon findings from the TRANS-IOTA (translational-international ovarian tumor analysis) study, expanding the biomarker panel to nine proteins, including CA125, HE4, CA72.4, and CCL11, alongside four additional biomarkers selected through systematic literature review.

The primary objective of BIOC is to develop a biomarker signature capable of distinguishing BOT from early-stage invasive ovarian cancer. This would allow for more accurate diagnoses either independently or in combination with ultrasound variables, thereby improving pre-surgical decision-making, reducing the need for second surgeries, and supporting more tailored treatments that improve patient outcomes. For younger patients with BOT, for instance, accurate differentiation could allow for fertility-preserving surgical options. A secondary aim of the study is to establish a robust database for BOT and stage I invasive ovarian cancer across Flanders (Belgium) and Europe, capturing detailed clinical, ultrasound, histological, and immune data that will guide future research and support gynecologists in refining their diagnostic approaches.

BIOC will be conducted across multiple hospitals in Flanders (Belgium) and a few European centers and aims to enroll 200 patients with BOT and 200 with stage I invasive ovarian cancer. Participants will primarily be recruited through gynecology ultrasound departments, where they will receive pre-surgical blood sampling and clinical evaluations. Recruitment will occur over three years, with the study concluding after a subsequent two-year analysis period, aiming for completion between 2028 and 2029.

By establishing a validated biomarker panel for early ovarian cancer diagnosis, BIOC has the potential to significantly enhance diagnostic accuracy and efficiency. This could transform the precision of preoperative assessments, reduce unnecessary invasive procedures, and improve overall treatment planning, thus enhancing patient outcomes and quality of life for those affected by ovarian cancer.