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1054 Blood-based detection of circulating dickkopf-1 as a prognostic biomarker in ovarian cancer patients
  1. P Wimberger1,2,
  2. DM Klotz1,2,
  3. T Link1,2,
  4. M Goeckenjan1,2,
  5. N Jaschke3,
  6. LC Hofbauer3,
  7. A Göbel3,
  8. TD Rachner3 and
  9. JD Kuhlmann1,2
  1. 1Technische Universität Dresden, Department of Gynecology and Obstetrics, Dresden, Germany
  2. 2National Center for Tumor Diseases, Partner site Dresden (NCT), Dresden, Germany
  3. 3Technische Universität Dresden, Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine III


Introduction/Background*Dickkopf-1 (DKK-1) is a secreted protein, known for suppressing the differentiation and activity of bone-building osteoblasts by acting as an inhibitor of Wnt-signalling. Soluble DKK-1 (sDKK-1) has been proposed as prognostic biomarker for a wide range of malignancies, however, clinical relevance of sDKK-1 as potential blood-based marker for ovarian cancer is unknown.

Methodology sDKK-1 levels were quantified in a cohort of 150 clinically documented ovarian cancer patients by a commercially available DKK-1 ELISA (Biomedica, Vienna, Austria).

Result(s)*Median sDKK-1 level was significantly elevated at primary diagnosis of ovarian cancer compared to healthy controls (estimated difference (ED) of 7.75 ng/mL (95%CI: 3.01 – 12.30 ng/mL, p = 0.001)). Higher levels of sDKK-1 at diagnosis indicated an increased volume of intraoperative malignant ascites (ED 7.08 pmol/L, 95%CI: 1.46 – 13.05, p = 0.02) and predicted suboptimal debulking surgery (ED 6.88 pmol/L, 95%CI: 1.73 – 11.87, p = 0.01). sDKK-1 did not correlate with CA125, and higher sDKK-1 levels predicted a higher risk of recurrence and poor survival (PFS: HR = 0.507, 95%CI: 0.317 – 0.809; p = 0.004; OS: HR = 0.561, 95%CI: 0.320 – 0.986; p = 0.044). Prognostic relevance of sDKK-1 was partly sustained in wtBRCA patients (PFS: HR = 0.507, 95%CI: 0.317 – 0.809; p = 0.004).

Conclusion*This is the first study demonstrating the prognostic relevance of sDKK-1 in ovarian cancer patients, including those with wtBRCA1/2 status. Our data encourage further evaluation of sDKK-1 in ovarian cancer patients, possibly in terms of a therapy monitoring marker or a response predictor for sDKK-1-directed targeted therapies.

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