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Biomarkers for cancer treatment

22 October 2013  •  Author(s): Amancio Carnero, Instituto de Biomedicina de Sevilla, Consejo Superior de Investigaciones Cient√≠ficas

There is an urgent need to predict which treatment will report the most benefit to a patient with cancer. To that end, scientists are exploring any possible biomolecule in the organism that can mark each individual for its adequate treatment. If achieved, it will open a personalised medicine era.

Introduction

Initial cancer treatments were based on medical experience. Empirically tested drugs were applied to tumours grouped by location, clinical features or size. As the understanding of the disease increased, anatomopathological analysis and clinical phenotype were included as the initial markers for tumour treatment selection. Different treatments were given to different tumour types and both were evolving together along with the discovery of new drugs. Nowadays, more than 200 types of tumours with many more subtypes can be identified, many more drugs, either cytotoxic or targeted, have been developed and a specific treatment is given to a patient according to a combination of clinical features, pathological analysis and molecular markers. However, this assignment is far from clear. For some time, the complexity of assigning an adequate treatment or predicting the individual response to a specific one, even if it is indicated to that type of tumour, has been an issue. Very few tumours are really cured by chemotherapy (for example, most testicular cancers with cisplatin), and in others, the same compound does not work. Why? Even in testicular cancers, around five per cent of tumours are not cured and progress; can we predict which ones? For most tumours and drugs, the whole population shows a relative improvement with some patients showing benefits while others do not. Can we identify these groups? The identification of markers of biological origin, or biomarkers, which enable predicting the response to cancer treatment, has become a research field in itself. A quick look on PubMed shows more than 200,000 entries for cancer biomarkers and more than 30,000 reviews on the topic. There are thousands of publications on every type of biomarker.

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