The importance of biomarkers in oncology
Cancer remains one of the main causes of death worldwide, according to the National Cancer Institute. Therefore, searching for more effective methods for early detection and treatment remains a crucial objective in medical research. In this context, biomarkers play a crucial role since they can be used to identify and understand the risk of developing cancer and the underlying mechanisms, diagnose a tumor at early stages, monitor disease progression, and evaluate the effectiveness or resistance to treatments [1]. Biomarkers can be found in blood, tissues, cerebrospinal fluid, or other bodily fluids. Examples of biomarkers include genes, proteins, hormones, antibodies, metabolites, and various cellular or structural components [1,2]. The use of biomarkers in cancer has been shown to increase patient survival because their early detection helps in choosing the most accurate treatment for a subset of patients.
In the context of personalized medicine, biomarkers are also important for tailoring treatments for individual patients based on their unique biological characteristics, allowing for more precise and effective medical interventions. In oncology treatment, the standard of care can improve outcomes for a large portion of the patients, however there are still notable subgroups of patients who do not respond. Researchers are turning to biomarkers to help explore why this may be the case. In summary, biomarkers have become powerful tools to help physicians make decisions in clinical practice.
Techniques for biomarker identification: the liquid biopsy
Detection technologies have advanced tremendously over the last decades, including techniques such as next-generation sequencing, nanotechnology, immunoassays, or methods to study circulating tumor DNA/RNA or exosomes. Additionally, proteomics and metabolomics are becoming promising approaches and techniques for the identification of biomarkers [2].
Liquid biopsy is an example of a novel technique for biomarker detection that has gained attention over the last few years. This minimally invasive type of biopsy is used to identify small fragments of DNA released by tumors into the bloodstream, known as circulating tumor DNA (ctDNA). These fragments circulate freely in the blood plasma from a very early stage of the disease when the tumor is still undetectable by conventional imaging techniques [3], underscoring their potential in medical research. ctDNA is increasingly being used by physicians as a highly sensitive tool in the decision-making process that can improve diagnosis, help in selecting the best treatment option, and facilitate cancer monitoring [4].
In the future, biomarkers are expected to play an even more prominent role in cancer prevention, diagnosis, and treatment. However, the detection and validation of accurate biomarkers in cancer currently represent a great challenge.
MEDSIR company committed with innovative research in oncology
MEDSIR was born as an independent clinical research company in oncology with the aim of enhancing the quality of life for cancer patients. At MEDSIR, we put all efforts into finding the best treatment for patients, including searching for innovative biomarkers that can help oncologists to better diagnose and characterize their patients’ disease, and even predict their response to therapy.
Recently, we performed an exploratory analysis to specifically investigate the role of the trophoblast cell-surface antigen-2 (Trop-2) protein as a predictive biomarker of response to treatment in HER2-positive early breast cancer (EBC) patients that were treated in a previously performed clinical trial, the PHERGain study.
Briefly, in the PHERGain phase II trial we evaluated a chemotherapy de-escalation strategy based on early response by PET scan to neoadjuvant therapy in this subset of patients. Three years after surgery, 98.8% of patients treated without chemotherapy throughout the whole study were still cancer-free (see the presentation at ASCO 2023).
After the trial was completed, we performed the Trop-2 sub analysis with a subgroup of patients treated with dual HER2 blockade plus chemotherapy from the beginning of the trial. We explored the correlation between Trop-2 and the pathological complete response (pCR). Interestingly, we found that Trop-2 expression (analyzed by immunohistochemistry) could be a potential biomarker of resistance to treatment in these patients and may become a strategic target for future combinations in HER2-positive EBC (Gion M, 2024).
With nearly 50 clinical trials and 10 translational studies conducted, MEDSIR has treated 2,300 patients since 2012, involved 430 researchers and 230 hospitals, and with the funding from more than 30 companies in the pharmaceutical and biotechnology industry. Collaboration between researchers, clinicians and industry will continue to be crucial to translate discoveries into meaningful clinical applications, thereby improving patients’ survival worldwide.
Contact us learn more about the innovative biomarker research at MEDSIR.
Bibliography
[1] Sarhadi VK, Armengol G. Molecular Biomarkers in Cancer. Biomolecules. 2022 Aug; 12(8): 1021.
[2] Alharbi RA. Proteomics approach and techniques in identification of reliable biomarkers for diseases. Saudi J Biol Sci. 2020 Mar; 27(3): 968–974.
[3] Santos-Pessoa L, Heringer M, Pereira-Ferrer V. ctDNA as a cancer biomarker: A broad overview. Critical Reviews in Oncology/Hematology 2020, 155:103109.
[4] Yoshinami, T., Kagara, N., Motooka, D., et al. Detection of ctDNA with personalized molecular barcode NGS and its clinical significance in patients with early breast Cancer. Transl. Oncol. 2020; 13: 100787.
