title: Challenges and methodology in the incorporation of biomarkers in cancer clinical trials.
abstract: Biomarkers can be used to establish more homogeneous groups using the genetic makeup of the tumour to inform the selection of treatment for each individual patient. However, proper preclinical work and stringent validation are needed before taking forward biomarkers into confirmatory studies. Despite the challenges, incorporation of biomarkers into clinical trials could better target appropriate patients, and potentially be lifesaving. The authors conducted a systematic review to describe marker-based and adaptive design methodology for their integration in clinical trials, and to further describe the associated practical challenges. Studies published between 1990 to November 2015 were searched on PubMed. Titles, abstracts and full text articles were reviewed to identify relevant studies. Of the 4438 studies examined, 57 studies were included. The authors conclude that the proposed approaches may readily help researchers to design biomarker trials, but novel approaches are still needed.
authors.affiliation: CRUK Imperial Centre, Department of Surgery and Cancer, Imperial College London, UK; Imperial Clinical Trials Unit, School of Public Health, Imperial College London, UK. Electronic address: c.wilhelm-benartzi@imperial.ac.uk.
authors.forename: Charlotte S
authors.initials: CS
authors.lastname: Wilhelm-Benartzi
authors.affiliation: Imperial Clinical Trials Unit, School of Public Health, Imperial College London, UK.
authors.forename: Shahrul
authors.initials: S
authors.lastname: Mt-Isa
authors.affiliation: Imperial Clinical Trials Unit, School of Public Health, Imperial College London, UK.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fiorentino
authors.affiliation: Epigenetics Unit, Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Brown
authors.affiliation: Imperial Clinical Trials Unit, School of Public Health, Imperial College London, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Ashby
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D002986:Clinical Trials as Topic; D006801:Humans; D009369:Neoplasms / Q000737:chemistry*; D012107:Research Design
chemical_list: D014408:Biomarkers, Tumor
keywords: Biomarkers; Cancer; Clinical trials; Research design; Statistical