What are cancer biomarkers

Biomarker Analysis: Added Value for Cancer Treatment

Biomarker analysis in cancer treatment

Thanks to the advances in medicine over the past 20 years, doctors now have a wide range of effective anti-cancer drugs at their disposal. It has therefore become a challenge to select the best and most effective remedy for each patient. Because even tumors of similar origin can differ in their reaction to drugs. The analysis of Biomarkers It now allows the molecular peculiarities of cancer cells to be recorded individually and thus provides valuable clues for choosing the right treatment strategy.


What are biomarkers and why are they relevant to cancer treatment?

A biomarker is a characteristic of a biological process that can be objectively measured and / or quantified and is therefore suitable for evaluation. The morphology (the “appearance”) of cancer cells has long been used as a biomarker to determine the tumor grade relevant for treatment.

Advances in molecular biology make it possible to evaluate so-called molecular-based biomarkers of cancer cells. These biomarkers describe changes in the molecules contained in the cell - DNA, RNA or proteins. A certain change in the genome (mutation) or the presence of a certain protein can be a biomarker. Since mutations are responsible for the fact that healthy cells degenerate into cancer cells, the evaluation of molecular-based biomarkers can provide valuable information on how the cancer originated and how it can be treated.


Molecular-based biomarkers in cancer as a guide in the choice of therapy

Biomarkers, the presence of which often coincides with the success or failure of a therapy, are of particular interest to doctors. It is also said that the biomarker is associated with the outcome of the therapy. These so-called predictive biomarkers1) can help to assess whether a therapy is useful for a particular patient.

This is how so-called targeted cancer drugs very specific to certain molecular changes that differentiate cancer cells from healthy tissue. Their effectiveness therefore depends on the cancer cells having these particular mutations. For example, vemurafenib (a selective inhibitor of the oncogene BRAF) is only prescribed if the cancer-promoting BRAF mutation V600E is present2).

But also the effectiveness of many Chemotherapy drugs is associated with biomarkers and can therefore be estimated in advance. This means that an individual biomarker profile can theoretically be created for each tumor, which allows conclusions to be drawn about the effectiveness of not one but many cancer drugs. We want to use this diagnostic potential.


Efficacy tests by evaluating molecular-based biomarkers

There are several methods of creating a biomarker profile of cancer cells. These test procedures differ in the types of biomarkers they look at and how they obtain the tumor material required for them.

Often times, samples of the tumor are taken and stored in the hospital at the beginning of the cancer diagnosis. These so-called tumor biopsies are - if they are not too old - very suitable for the analysis of molecular-based biomarkers. As a rule, genomic biomarkers are evaluated - biomarkers that describe certain mutations in the genome of cancer cells.

  • The one we offer PCDx ™ test (Paradigm Diagnostics, Inc.) combines this with the additional evaluation of RNA and protein biomarkers. As a result, the test can predict more drug effects than classic genome analyzes. In addition to the effectiveness of targeted drugs also those of Chemotherapy drugs analyze. This test is one of the most comprehensive analysis methods for therapy selection on the market. In addition, the test achieves a particularly high level of precision thanks to this multi-platform analysis.

In the case of more advanced diseases, it is also possible to isolate the necessary genetic material of the cancer cells directly from the blood. This method is called "liquid biopsy".

  • Tests like the one we offer Guardant360®-Test (Guardant Health, Inc.) then evaluate genetic biomarkers using very sensitive DNA sequencing. By doing this, they say the tumor is primarily sensitive to targeted drugs before. The Guardant360 test stands out on the market in that it can sequence or detect a particularly large number of genetic biomarkers of the tumor with the highest sensitivity.

Molecular-based biomarkers or direct efficacy testing of cancer drugs?

The prediction of effectiveness using molecular-based biomarkers is a indirect testing. The predictive power of biomarker tests is therefore strongly dependent on how strongly the presence of the tested biomarkers and the therapy outcome are associated with one another. Regardless of this, in order to always achieve accurate and reliable predictions, many molecular-based biomarkers have to be included and large amounts of data have to be generated.

More direct The effectiveness of cancer drugs can be determined by evaluating them Microtumor-Based Biomarkers testing. One such biomarker is that Chemosensitivity, which describes the sensitivity of cancer cells to certain drugs.

  • Chemosensitivity tests like the one we offer CTR test® determine whether the patient's own cancer cells can multiply even though they are treated with drugs that are suitable for therapy. This method is particularly suitable for determining resistance of cancer cells to chemotherapy in advance.

additional Information

For more detailed information on cancer diagnostics and the services of TherapySelect, please continue reading under "Which test for whom?"

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1) https://www.krebsinformationsdienst.de/untersprüfung/tumormarker- Background.php#inhalt11

2) http://www.ema.europa.eu/docs/de_DE/document_library/EPAR_-_Product_Information/human/002409/WC500124317.pdf