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The OVA1 Next Generation test is a qualitative serum test that combines the results of five immunoassays into a single numeric result. It is indicated for women who meet the following criteria: over age 18, ovarian adnexal mass present for which surgery is planned, and not yet referred to an oncologist. The OVA1 Next Generation test is an aid to further assess the likelihood that malignancy is present when the physician's independent clinical and radiological evaluation does not indicate malignancy. The test is not intended as a screening or stand-alone diagnostic assay.

The OVA1 Next Generation (NG) test consists of software, instruments, assays and reagents. The software incorporates the results of serum biomarker concentrations from five immunoassays to calculate a single, unitless numeric result indicating a low or high risk of ovarian malignancy. The assays used to generate the numeric result (OVA1 NG test result) are APO, CA 125 II, FSH, HE4 and TRF. Biomarker values are determined using assays on the Roche cobas® 6000 system, which is a fully automated, software-controlled system for clinical chemistry and immunoassay analysis. The biomarker assays are run according to the manufacturer's instructions as detailed in the package insert for each reagent. The OVA1 NG software (OvaCalc v4.0.0) contains a proprietary algorithm that utilizes the results (values) from the five biomarker assays, (APO, CA 125 II, FSH, HE4 and TRF). The assay values from the cobas 6000 system are either imported into OvaCalc through a .csv file or manually entered into the OvaCalc user interface to generate an OVA1 NG test result between 0.0 and 10.0. A low- or high-risk result is then determined by comparing the software-generated risk score to a single cutoff (low-risk result <5. high-risk result ≥5).

The OVA1™ Test is a qualitative serum test that combines the results of five immunoassays into a single numerical score. It is indicated for women who meet the following criteria: over age 18; ovarian adnexal mass present for which surgery is planned, and not yet referred to an oncologist. The OVA 1 Test is an aid to further assess the likelihood that malignancy is present when the physician's independent clinical and radiological evaluation does not indicate malignancy. The test is not intended as a screening or stand-alone diagnostic assay. PRECAUTION: The OVA1™ Test should not be used without an independent clinical/radiological evaluation and is not intended to be a screening test or to determine whether a patient should proceed to surgery. Incorrect use of the OVA1™ Test carries the risk of unnecessary testing, surgery, and/or delayed diagnosis.

The OVA1™ Test uses OvaCalc Software to incorporate the values for 5 analytes from separately run immunoassays (described below) into a single numerical score between 0.0 and 10.0. The cleared test system consists of the software, instruments, assays and reagents used to obtain the OVA1™ Test result. The immunoassays and reagents are sold separately from the OvaCalc Software. Users are instructed to use only those lots identified by Vermillion. The immunoassays are performed according to the manufacturers' directions detailed in each product insert. The analytes and corresponding tests and calibrators used in the OVA1™ Test are: | Analyte | Device (Assay and Calibrator) | Instrument | |-----------------------|-----------------------------------------------------------------------------------------------------------|--------------------| | CA 125 | Elecsys CA 125 II<br>CA125 II CalSet | Roche Elecsys 2010 | | Prealbumin | N Antisera to Human Prealbumin and<br>Retinal-binding Protein<br>N Protein Standard SL (human) | Siemens BN II | | Apolipoprotein<br>A-1 | N-Antisera to Human Apolipoprotein A-1<br>and Apolipoprotein B<br>N Apolipoprotein Standard Serum (human) | Siemens BN II | | β2-microglobulin | Human Beta-2 Microglobulin Latex<br>Enhanced Nephelometric Kit (Binding Site) | Siemens BN II | | Transferrin | N Antisera to Human Transferrin and<br>Haptoglobin<br>N Protein Standard SL (human) | Siemens BN II | The user enters results of the five analytes manually into an Excel spreadsheet together with the headers needed by OvaCalc Software. There is no physical or electronic connection between the immunoassay devices and the OvaCalc Software. Using an algorithm and the values of these 5 analytes, the OvaCalc Software generates a single unit-less numerical score from 0.0 to 10.0.