The unacceptably high morbidity and mortality associated with the diagnosis of lung cancer mandates new approaches toward the early detection and treatment of this disease. Enhanced understanding of the molecular biology of the carcinogenic process is identifying many potential markers of risk of lung cancer occurrence as well as of poor prognosis. Identification of high risk populations who are at greatest risk of being diagnosed with and dying from lung cancer would allow delivery of more intensive screening and interventions to the individuals who are most likely to benefit from such strategies. This review examines the current status of markers of lung cancer risk, early detection, and prognosis, and their applicability to current standards of clinical care.

Jason S. Vourlekis

Eva Szabo

Use of Markers for the Detection and Treatment of Lung Cancer

We provide a general framework for describing various roles for biomarkers in cancer prevention research (early detection, surrogate endpoint, and cohort identification for primary prevention) and the phases in their evaluation.

Stuart G. Baker

Barnett S. Kramer

Philip C. Prorok

Development Tracks for Cancer Prevention Markers

The elucidation of the human genome and advances in knowledge about molecular abnormalities, signaling pathways, influence of the local tissue milieu and the relevance of genetic polymorphisms offer hope of designing more effective, individualized cancer treatment plans. Although the scientific and medical literature is replete with reports of putative prognostic or predictive markers for cancer, few new diagnostics have been incorporated into routine clinical practice. Criteria are needed to a) identify markers that have the promise to be clinically useful; b) assess the best methodology for clinical evaluation of the markers in question and c) confirm or validate that using the marker adds useful information compared to using standard prognostic factors alone. This review presents a methodology for the clinical evaluation of putative prognostic and predictive markers in cancer, with considerations of pitfalls in the early evaluation, rationale for development and optimization of assay methodology, and examples of possible clinical trials for assessing the clinical utility of putative markers.

Barbara A. Conley

Sheila E. Taube

Prognostic and Predictive Markers in Cancer

Asad Umar

Sudhir Srivastava

The Promise of Biomarkers in Colorectal Cancer Detection

Kathryn L. Terry

Patrick M. Sluss

Steven J. Skates

Samuel C. Mok

Bin Ye

Allison F. Vitonis

Daniel W. Cramer

Blood and Urine Markers for Ovarian Cancer: A Comprehensive Review

Ziding Feng

Yutaka Yasui

Statistical Considerations in Combining Biomarkers for Disease Classification

Approximately 1 man in 6 will be diagnosed with prostate cancer during his life lifetime, and over 200,000 men in the U.S. are diagnosed with prostate cancer annually. Since the widespread adoption of PSA testing, about 60&#x2013;70&#x25; of men at risk in the U.S. have had a blood test for prostate cancer. With this, prostate cancer death rates have decreased, yet only slightly. Thirty thousand men still die each year from this disease. PSA testing fails to identify a small but significant proportion of aggressive cancers, and only about 30&#x25; of men with a &#x201c;positive&#x201d; PSA have a positive biopsy. Additionally, of men who are treated for prostate cancer, about 25&#x25; require additional treatment, presumably due to disease recurrence. Also of concern is the growing evidence that there are some prostate cancers for which treatment may not be necessary. Very long-term studies from the U.S. and Europe, following men with prostate cancer have found that some tumors do not progress over time. In these individuals, prostate cancer treatment is unnecessary and harmful as these men do not benefit from treatment but will be at risk of treatment-related side effects and complications. They suggest a fundamental problem with prostate cancer: it is not possible, at this time, to predict the natural history of the disease. It is for these reasons that the most important challenge in prostate cancer today is the inability to predict the behavior of an individual tumor in an individual patient. Here we review issues related to performance and validation of biomarkers with a focus on &#x201c;doing no harm&#x201d;, and bearing in mind that it is the ultimate goal of early detection to save lives. Improved diagnostic and prognostic biomarkers are needed for prostate cancer, and the use of these markers should ultimately translate into increased life span and quality of life. The ultimate goal would be to not only have accurate biomarkers suitable for early diagnosis, but also biomarkers that identify men at greatest risk of developing aggressive disease. Technology has been brought to bear on this problem, and the major approaches are genomics, expression analysis, and proteomics. Proteomics and DNA methylation assays may soon be used in sensitive and specific diagnostic testing of serum and tissues for cancer. Expression arrays may be used to establish both a more specific diagnosis and prognosis for a particular tumor. The proteome is only beginning to be understood, and alternative splicing and post-translational modifications of proteins such as glycosylation and phosphorylation are challenging areas of study. Finally, risk assessment and prognosis are being pursued through analysis of genomic polymorphisms (single nucleotide polymorphisms, SNPs). This huge task is only beginning, and requires the combined expertise of molecular epidemiologists, oncologists, surgeons, pathologists, and basic scientists.

D. A. Troyer

J. Mubiru

R. J. Leach

S. L. Naylor

Promise and Challenge: Markers of Prostate Cancer Detection, Diagnosis and Prognosis

Elizabeth R. Unger

Martin Steinau

Mangalathu S. Rajeevan

David Swan

Daisy R. Lee

Suzanne D. Vernon

Molecular Markers for Early Detection of Cervical Neoplasia

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Disease Markers publishes papers related to the identification of disease markers, the elucidation of their role and mechanism, as well as their application in the prognosis, diagnosis and treatment of diseases.

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Chief Editor Paola Gazzaniga is an Associate Professor in the Department of Molecular Medicine at Sapienza University of Rome, Italy. Her core research focuses on liquid biopsies in patients with solid tumors.

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Disease Markers publishes papers related to the identification of disease markers, the elucidation of their role and mechanism, as well as their application in the prognosis, diagnosis and treatment of diseases.

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Disease Markers | Hindawi

Disease Markers

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