title: Tissue-based approaches to study pharmacodynamic endpoints in early phase oncology clinical trials.
abstract: Anti-cancer clinical drug development is currently costly and slow with a high attrition rate. There is thus an urgent and unmet need to integrate pharmacodynamic biomarkers into early phase clinical trials in the framework provided by the "pharmacologic audit trail" in order to overcome this challenge. This review discusses the rationale, advantages and disadvantages, as well as the practical considerations of various tissue-based approaches to perform pharmacodynamic studies in early phase oncology clinical trials using case histories of molecular targeting agents such as PI3K, m-TOR, HSP90, HDAC and PARP inhibitors. These approaches include the use of normal "surrogate" tissues such as peripheral blood mononuclear cells, platelet-rich plasma, plucked hair follicles, skin biopsies, plasma-based endocrine assays, proteomics, metabolomics and circulating endothelial cells. In addition, the review discusses the use of neoplastic tissues including tumor biopsies, circulating tumor DNA and tumor cells and metabolomic approaches. The utilization of these tissues and technology platforms to study biomarkers will help accelerate the development of molecularly targeted agents for the treatment of cancer.
authors.affiliation: The Institute of Cancer Research, Sutton, UK.
authors.forename: Joo Ern
authors.initials: JE
authors.lastname: Ang
authors.forename: Stan
authors.initials: S
authors.lastname: Kaye
authors.forename: Udai
authors.initials: U
authors.lastname: Banerji
mesh_terms: D000970:Antineoplastic Agents / Q000737:chemistry / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D001706:Biopsy; D002986:Clinical Trials as Topic / Q000379:methods*; D015195:Drug Design; D023381:Endpoint Determination; D023281:Genomics / Q000379:methods; D006801:Humans; D046228:Microarray Analysis / Q000379:methods; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D040901:Proteomics / Q000379:methods; D012107:Research Design; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor