Longitudinal Plasma Proteomic Remodeling in Ovarian Cancer (TLPPROC)

July 2, 2026 updated by: University Medical Centre Ljubljana

Treatment-Associated Longitudinal Plasma Proteomic Remodeling in Ovarian Cancer

This longitudinal observational study investigates treatment-associated changes in the circulating plasma proteome of patients with ovarian cancer undergoing standard treatment. Although CA125 and HE4 are established biomarkers for monitoring treatment response, they provide only a limited view of the complex biological processes occurring during therapy.

The study includes patients with epithelial ovarian cancer and primary peritoneal Müllerian tumors who underwent surgery and/or platinum-based chemotherapy. Plasma samples were collected at three predefined treatment timepoints: before surgery (T1), after surgery (T2), and after completion of chemotherapy (T3). A panel of 92 circulating proteins was quantified using Olink proximity extension assay technology. Longitudinal proteomic changes were evaluated in relation to established clinical biomarkers (CA125 and HE4), exploratory proliferation-associated biomarker thymidine kinase 1 (TK1), and KELIM-defined chemosensitivity.

The primary objective is to characterize treatment-associated remodeling of the circulating proteome and determine whether these molecular changes reflect tumor burden reduction, treatment exposure, or chemotherapy sensitivity. Secondary objectives include identification of proteins and biological pathways associated with treatment timepoints and assessment of concordance between proteomic changes and established clinical biomarkers.

This study aims to improve understanding of dynamic tumor-host interactions during ovarian cancer treatment and to explore the potential role of longitudinal proteomic profiling as a complement to conventional biomarker monitoring.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

33

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Slovenia
      • Ljubljana, Slovenia
        • UMC Ljubljana

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age ≥18 years.
  • Histologically confirmed epithelial ovarian cancer or primary peritoneal Müllerian carcinoma.
  • Undergoing standard treatment including surgery and/or systemic therapy.
  • Availability of plasma samples collected at one or more predefined treatment timepoints (pre-operative, post-operative, and/or post-chemotherapy).
  • Availability of corresponding clinical and biomarker data (CA125 and/or HE4).
  • Written informed consent

Exclusion Criteria

  • Non-epithelial ovarian malignancies.
  • Insufficient plasma sample volume or inadequate sample quality for proteomic analysis.
  • Missing essential clinical data required for study analyses.
  • Withdrawal of informed consent.
  • Concurrent participation in another study that would prevent interpretation of biomarker analyses.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Standard-of-Care Ovarian Cancer Treatment
Patients with epithelial ovarian cancer or primary peritoneal Müllerian tumors undergoing standard clinical management, including primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery, platinum-based chemotherapy, and maintenance therapy when clinically indicated. Serial plasma samples were collected for longitudinal proteomic analysis.
Other: Longitudinal Plasma Biomarker Assessment
Serial plasma sampling and proteomic profiling using Olink proximity extension assay technology performed at predefined treatment timepoints (pre-operative, post-operative, and post-chemotherapy). Clinical biomarkers including CA125, HE4, thymidine kinase 1 (TK1), and KELIM-defined chemosensitivity were analyzed in relation to longitudinal proteomic changes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment-associated changes in circulating plasma protein levels
Time Frame: Time 1 (Baseline, prior to primary cytoreductive surgery); Time 2 (1 month after primary cytoreductive surgery); Time 3 (after completion of first-line chemotherapy, up to 12 months after treatment initiation).
Identification of circulating proteins significantly associated with treatment timepoint (pre-operative, post-operative, and post-chemotherapy) as measured by Olink normalized protein expression (NPX) values and analyzed using longitudinal mixed-effects models.
Time 1 (Baseline, prior to primary cytoreductive surgery); Time 2 (1 month after primary cytoreductive surgery); Time 3 (after completion of first-line chemotherapy, up to 12 months after treatment initiation).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in serum CA125 and HE4 concentrations across treatment timepoints and their association with longitudinal proteomic remodeling.
Time Frame: Time 1 (Baseline, prior to surgery); Time 2 (1 month after primary cytoreductive surgery); Time 3 (after completion of first-line chemotherapy, up to 12 months after treatment initiation).
Correlation between changes in plasma protein levels and changes in CA125 and HE4 concentrations between baseline (Time 1) and post-treatment measurements (Time 2 and Time 3).
Time 1 (Baseline, prior to surgery); Time 2 (1 month after primary cytoreductive surgery); Time 3 (after completion of first-line chemotherapy, up to 12 months after treatment initiation).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Medical Centre Ljubljana

Collaborators

Helmholtz Zentrum München

Investigators

  • Study Director: Joško Osredkar, Prof, PhD, Institute of Clinical Chemistry and Biochemistry, Ljubljana University Medical Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • [1] Konstantinopoulos PA, Matulonis UA. Clinical and translational advances in ovarian cancer therapy. Nat Cancer. 2023 Sep;4(9):1239-1257. doi: 10.1038/s43018-023-00617-9. [2] Whitwell HJ, Worthington J, Blyuss O, Gentry-Maharaj A, Ryan A, Gunu R et al. Improved early detection of ovarian cancer using longitudinal multimarker models. Br J Cancer. 2020 Mar;122(6):847-856. doi: 10.1038/s41416-019-0718-9. [3] Charkhchi P, Cybulski C, Gronwald J, Wong FO, Narod SA, Akbari MR. CA125 and Ovarian Cancer: A Comprehensive Review. Cancers (Basel). 2020 Dec 11;12(12):3730. doi: 10.3390/cancers12123730. [4] Alegría-Baños JA, Jiménez-López JC, Vergara-Castañeda A, de León DFC, Mohar-Betancourt A, Pérez-Montiel D et al. Kinetics of HE4 and CA125 as prognosis biomarkers during neoadjuvant chemotherapy in advanced epithelial ovarian cancer. J Ovarian Res. 2021 Jul 19;14(1):96. doi: 10.1186/s13048-021-00845-6. [5] You B, Colomban O, Heywood M, Lee C, Davy M, Reed N et al. The strong prognostic value of KELIM, a model-based parameter from CA 125 kinetics in ovarian cancer: data from CALYPSO trial (a GINECO-GCIG study). Gynecol Oncol. 2013 Aug;130(2):289-94. doi: 10.1016/j.ygyno.2013.05.013. [6] Lauby A, Colomban O, Corbaux P, Peron J, Van Wagensveld L, Gertych W et al. The Increasing Prognostic and Predictive Roles of the Tumor Primary Chemosensitivity Assessed by CA-125 Elimination Rate Constant K (KELIM) in Ovarian Cancer: A Narrative Review. Cancers (Basel). 2021 Dec 25;14(1):98. doi: 10.3390/cancers14010098. [7] Bradbury M, Borràs E, Pérez-Benavente A, Gil-Moreno A, Santamaria A, Sabidó E. Proteomic Studies on the Management of High-Grade Serous Ovarian Cancer Patients: A Mini-Review. Cancers (Basel). 2021 Apr 25;13(9):2067. doi: 10.3390/cancers13092067. [8] Qian L, Zhu J, Xue Z, et al. Proteomic landscape of epithelial ovarian cancer. Nat Commun. 2024;15(1):6462. doi: 10.1038/s41467-024-50786-z. [9] Li Y, Wang B, Yang W, Ma F, Zou J, Li K, Tan S, Feng J, Wang Y, Qin Z,

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 23, 2021

Primary Completion (Actual)

January 7, 2025

Study Completion (Actual)

March 10, 2025

Study Registration Dates

First Submitted

June 1, 2026

First Submitted That Met QC Criteria

July 2, 2026

First Posted (Actual)

July 6, 2026

Study Record Updates

Last Update Posted (Actual)

July 6, 2026

Last Update Submitted That Met QC Criteria

July 2, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KOG UMC LJUBLJANA

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

The data that support the findings of the study are available from the corresponding author upon reasonable request.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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