title: Pathways to implementation of serum proteomics for cancer.
abstract: Proteomic and genomic technologies have been developed that can simultaneously detect large panels of cancer biomarkers in body fluids such as serum, plasma, sputum, saliva or urine. These approaches provide great promise for the early detection of cancer, but have thrust the field into the era of diagnostic multianalyte-based cancer tests with few, if any, models for the implementation of such tests. These multianalyte tests may be based on the detection of serum antibodies to tumor antigens, the presence of cancer-related proteins in serum or the presence of tumor-specific genomic changes that appear in plasma as free DNA. The application of noninvasive diagnostic approaches to detect early stage cancer will provide the physician with greater presymptomatic periods for clinical intervention, but it is uncertain how the various forces will impact their implementation in a patient care setting. Utilization will be balanced by medical follow-up pathways, commercial/reimbursement factors and regulatory issues that influence implementation of new devices in the marketplace.
authors.affiliation: Karmanos Cancer Institute/Wayne State University School of Medicine, Program in Molecular Biology and Genetics, Department of Pathology, 110 E. Warren, Detroit, MI 48201, USA.
authors.forename: Madhumita
authors.initials: M
authors.lastname: Chatterjee
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Levin
authors.forename: Jay P
authors.initials: JP
authors.lastname: Shah
authors.forename: Alexei
authors.initials: A
authors.lastname: Ionan
authors.forename: Harry E
authors.initials: HE
authors.lastname: Grates
authors.forename: Michael A
authors.initials: MA
authors.lastname: Tainsky