Response biomarkers: re-envisioning the approach to tailoring drug therapy for cancer.
The rapidly expanding arsenal of chemotherapeutic agents approved in the past 5 years represents significant progress in the field. However, this poses a challenge for oncologists to choose which drug or combination of drugs is best for any individual. Because only a fraction of patients respond to any drug, efforts have been made to devise strategies to personalize care. The majority of efforts have involved development of predictive biomarkers. While there are notable successes, there are no predictive biomarkers for most drugs. Moreover, predictive biomarkers enrich the cohort of individuals likely to benefit; they do not guarantee benefit.



There is a need to devise alternate strategies to tailor cancer care. One alternative approach is to enhance the current adaptive approach, which involves administration of a drug and cessation of treatment once progression is documented. This currently involves radiographic tests for the most part, which are expensive, inconvenient and imperfect in their ability to categorize patients who are and are not benefiting from treatment. A biomarker approach to categorizing response may have advantages.



Herein, we discuss the state of the art on treatment response assessment. While the most mature technologies for response assessment involve radiographic tests such as CT and PET, reports are emerging on biomarkers used to monitor therapeutic efficacy. Potentially, response biomarkers represent a less expensive and more convenient means of monitoring therapy, although an ideal response biomarker has not yet been described. A framework for future response biomarker discovery is described.
Cumming School of Medicine, Faculty of Graduate Studies, University of Calgary, Calgary, Canada.|University of Calgary, Arnie Charbonneau Cancer Research Institute, Health Research Innovation Centre, 2AA-07, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
Shahil
S
Amin
Department of Surgery, University of Calgary, Calgary, Canada. bathe@ucalgary.ca.|Department of Oncology, University of Calgary, Calgary, Canada. bathe@ucalgary.ca.|University of Calgary, Arnie Charbonneau Cancer Research Institute, Health Research Innovation Centre, 2AA-07, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada. bathe@ucalgary.ca.|Tom Baker Cancer Center, 1131 29th Street NW, Calgary, AB, T2N 4 N2, Canada. bathe@ucalgary.ca.
Oliver F
OF
Bathe
D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D057285:Precision Medicine; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
Adaptive biomarker; Assessing response; Cancer; Predictive biomarker; RECIST; Response Biomarker; Systemic therapy