Personalized therapy of sarcomas: integration of biomarkers for improved diagnosis, prognosis, and therapy selection.
An improved understanding of cancer's molecular diversity at the genetic, proteomic, and epigenetic levels has made it evident that "sarcoma" comprises more than 50 different types, each as unique as, for example, breast carcinoma is from colon carcinoma. Sarcomas exhibit characteristic differences in cell of origin, disease site, likelihood and site of metastasis, growth propensity, and chemosensitivity. Additionally, as many as one third of sarcomas harbor specific chromosomal translocations that can be used to discriminate one subtype from another. Although biomarkers can be integrated into clinical practice to improve diagnostic accuracy and predict treatment response, a number of challenges hinder their widespread use. This review addresses the current use of biomarkers for clinical oncology, with special emphasis on diagnosis, staging, and grading. It also discusses types of biomarkers that are emerging to aid selection of therapy for patients with sarcoma. Finally, we consider practical factors that appear to limit biomarker integration into clinical practice.
Ludwig
Joseph A
JA
Laboratory of Sarcoma Molecular Therapeutics, Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Unit 450, 1515 Holcombe Boulevard, Houston, TX 77030, USA. jaludwig@mdanderson.org
D014408:Biomarkers, Tumor / Q000032:analysis*; D006801:Humans; D011379:Prognosis; D012509:Sarcoma / Q000737:chemistry / Q000175:diagnosis / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000628:therapy
D014408:Biomarkers, Tumor
J Clin Oncol. 1996 Apr;14(4):1245-51
8648380
Ann N Y Acad Sci. 2003 Mar;983:142-50
12724219
J Clin Oncol. 2005 Dec 1;23(34):8828-34
16314643
J Clin Oncol. 1993 Mar;11(3):449-53
8445419
Cancer Res. 1999 Apr 1;59(7):1428-32
10197607
Cancer. 2005 May 1;103(9):1881-90
15772959
Mol Med. 2000 Jan;6(1):50-9
10803408
CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66
17237035
J Clin Oncol. 2007 Nov 1;25(31):4909-13
17971587
Cancer. 2001 Aug 15;92(4):869-74
11550160
J Pathol. 2006 Apr;208(5):624-32
16463269
Jpn J Clin Oncol. 2007 Dec;37(12):955-60
18211986
Cancer. 2005 Jan 15;103(2):402-8
15578681
Semin Oncol. 2002 Jun;29(3):294-300
12063683
Mol Cancer Res. 2007 Oct;5(10):991-9
17951400
J Clin Oncol. 2008 Feb 10;26(5):729-35
18258980
J Clin Oncol. 1998 Apr;16(4):1248-55
9552022
Urol Oncol. 2000 Sep 1;5(5):214-216
10973710
Oncology. 2005;69(4):326-32
16293972
J Clin Oncol. 2002 Feb 1;20(3):776-90
11821461
Int J Cancer. 2001 May 20;95(3):168-75
11307150
Cell Mol Biol Lett. 2007;12(4):556-72
17588222
J Clin Oncol. 2002 Feb 1;20(3):791-6
11821462
J Clin Oncol. 2007 May 1;25(13):1760-4
17470866
Nat Genet. 2003 Mar;33 Suppl:238-44
12610533
J Clin Oncol. 2001 Feb 15;19(4):980-91
11181660
Cancer. 2004 Nov 15;101(10):2270-5
15484214
Wien Klin Wochenschr. 2004 Feb 28;116(4):135-9
15038405
J Clin Oncol. 2005 Dec 20;23(36):9369-76
16361637
Future Oncol. 2007 Aug;3(4):381-92
17661712
Oncol Rep. 2003 Jan-Feb;10(1):181-4
12469167
N Engl J Med. 2001 Apr 5;344(14):1038-42
11287973
Clin Exp Metastasis. 2008;25(4):427-35
18301993
Clin Orthop Relat Res. 2007 Jun;459:229-36
17353802
Nat Biotechnol. 2003 Jul;21(7):742-3
12833089
J Orthop Res. 2007 Jan;25(1):116-21
17034065
Cancer Res. 2000 Sep 15;60(18):5134-42
11016640
J Clin Oncol. 1992 Jan;10(1):5-15
1370176
Semin Oncol. 2002 Jun;29(3):213-21
12063674
J Natl Cancer Inst. 2001 Jul 18;93(14):1054-61
11459866
J Clin Oncol. 2007 Jul 1;25(19):2755-63
17602081
Nat Rev Cancer. 2005 Nov;5(11):845-56
16239904
Oncogene. 2007 Nov 1;26(50):7170-4
17525744
Semin Surg Oncol. 2003;21(1):3-7
12923909
Cancer. 2006 Apr 1;106(7):1617-23
16518826
Oncologist. 2002;7(4):348-59
12185297
Pediatr Radiol. 2004 Aug;34(8):595-605
15103428
Cancer. 2007 Sep 15;110(6):1351-60
17661343
J Clin Oncol. 1997 Feb;15(2):583-8
9053480