Clinically Meaningful Use of Blood Tumor Markers in Oncology

Abstract

Before the introduction of modern imaging techniques and the recent developments in molecular diagnosis, tumor markers (TMs) were among the few available diagnostic tools for the management of cancer patients. Easily obtained from serum or plasma samples, TMs are minimally invasive and convenient, and the associated costs are low. Single TMs were traditionally used but these have come under scrutiny due to their low sensitivity and specificity when used, for example, in a screening setting. However, recent research has shown superior performance using a combination of multiple TMs as a panel for assessment, or as part of validated algorithms that also incorporate other clinical factors. In addition, newer TMs have been discovered that have an increased sensitivity and specificity profile for defined malignancies. The aim of this review is to provide a concise overview of the appropriate uses of both traditional and newer TMs and their roles in diagnosis, prognosis, and the monitoring of patients in current clinical practice. We also look at the future direction of TMs and their integration with other diagnostic modalities and other emerging serum based biomarkers, such as circulating nucleic acids, to ultimately advance diagnostic performance and improve patient management.

Asynchronous replication in oncological patients

“…К функциональным (эпигенетическим) маркерам относят все нарушения, которые не связаны с изменениями структуры ДНК, но приводят к изменениям в уровне экспрессии генов, участвующих в процессах канцерогенеза. Для многих видов онкологических патологий существующие на данный момент молекулярно-генетические маркеры или их сочетание позволяют определить начальные стадии, прогноз развития заболевания, подобрать оптимальную тактику лечения и разработать таргетные терапевтические средства [1][2][3][4][5][6]. Тем не менее, несмотря на то, что для многих типов онкологических патологий выявлены характерные генетические и эпигенетические нарушения, постоянно проводятся исследования по созданию и внедрению в клиническую практику новых молекулярно-генетических и биохимических маркеров, что дает мощный импульс для развития диагностики, позволяющей прогнозировать риски развития заболеваний, их обнаружения на ранних стадиях, течение болезни, тактику лечения и осуществлять мониторинг рецидивирования.…”

Tumor-Associated Autoantibodies: Re-Optimization of EarlyCDT-Lung Diagnostic Performance and Its Application to Indeterminate Pulmonary Nodules

“…Tumor-associated (TA) antigens are currently the most commonly measured biomarkers during management of cancer patients [6]. However they are often of little utility in early disease due to serum levels having a strong correlation with tumor burden.…”

Making Meaningful Clinical Use of Biomarkers

“…Numerous newer disease signatures have been identified as mentioned earlier, but none has been clinically validated for routine use. Several additional reviews have addressed the misconceptions and shortcomings that contribute to the void between discovery and meaningful clinical use to replace current reference standards 1,24,25…”