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MEPI talked about the role of biomarkers in personalised treatment of cancer

Personalized and precision medicine (APM) is becoming the main direction of development of medical science and practice. Its main task is to determine which drugs will be effective for the patient, given its genetic characteristics and individual forms of the disease, and also for his immediate family. Over time, personalized medicine using biomarkers will be a critical part of preventive and curative work of doctors-oncologists and will help to reduce the risk of illness for people from risk groups.

 What is a biomarker? This is a characteristic that can be objectively evaluated to identify pathological or physiological process in the human body. Biomarkers are used, for example, to assess the stage of the disease, prognosis and selection of individual treatment regimens, depending on the molecular type of the tumor.

For example, in patients suffering from breast cancer or lung cancer, tumors contain typical genetic mutation. In this regard, in the world of Oncology practice so patients taken to conduct targeted genome scan, and to determine individual range of biomarkers to adequately generate targeted (targeted) therapy.

Biomarkers come in three main types, told MIA «Russia Today» head of the Department of translational medicine, NRNU MEPhI, Professor Sergei Suchkov. «Predictive biomarkers predict the risks of disease occurrence and the most likely response to planned and ongoing treatment. Give prognostic information about how the disease can occur regardless of the type of treatment, that is, determine the prognosis of the disease. Diagnostic allow you to put the correct diagnosis at the right time,» he explained.

Numerous studies have identified a number of biomarkers associated with tumors. Their definition in a single package (multifactorial screening and monitoring) increases the accuracy of diagnosis and even pre-cancerous condition, and the reliability of the forecast, optimization of the procedure for the identification of metastases.

Ancillary study of biomarkers is a mandatory part of the diagnostic and treatment protocols for cancer patients and preventive-preventive protocols for individuals at risk. This method gives oncologists a unique tool for clinical guidance and helps patients achieve maximum long life without relapses.

Biomarkers can significantly improve the diagnosis of malignant tumors, facilitating the Clinician design the most effective schemes of treatment. It is the biomarkers were given a real boost to the development of the concept of targeted therapy. Researchers have realized the need to create a special «targeted» drugs are able to establish themselves in the key stages of pathogenesis and correct them.

In 2011, the U.S. Commission on food and drug administration (FDA) has approved a number of ordinances targeted at oncotherapy. Two of them related to drugs krizotinib and vemurafenib, have become unique. For the first time the basis of the choice methods of treatment were not due to the subjective views of the attending physician, and the objective principles of biomarkerbased.

Now to the purpose krizotinib therapy, physicians must conduct a test based on a unique method of fluorescence (FISH-method). This test helps to identify genomic rearrangements, which suggests that this patient may have to obtain special benefit from treatment with kristinia.

«The use of new and extraordinarily robust method for rapid screening of biomolecules associated with cancer has allowed scientists to construct a unique panel of biomarkers predannih stages of tumor process (biprediction). This toolbar not only helps to choose a highly effective therapy for breast cancer, but also provide an infallible diagnosis of the disease in the beginning of development,» said Sergei Suchkov.

Metastatic melanoma is a dangerous disease with a poor prognosis for most patients. Therefore, the decision on inclusion in clinical guidelines of the drug vemurafenib, which helps approximately 40-60% of patients with this diagnosis, has become a unique importance. The use of vemurafenib for the first time provided a significant increase in the survival from this deadly disease. However, the drug is not active in some patients, so they all must pass a preliminary examination for the presence of an appropriate biomarker.

Another example is drug brentuximab vedotin intended for the treatment of patients with Hodgkin’s lymphoma. Previously these patients tried to treat autologous stem cells, but many of them died. And brentuximab that combines targeted monoclonal antibodies with artificially created small molecules, provides a powerful medicinal effect, causing the death of cancer cells and inhibiting their reproduction. In the framework of clinical trials in Hodgkin’s lymphoma the frequency of positive effect was 73% and almost 32% of the patients reached complete remission.

The identification of specific biomolecules in the composition of the seminal fluid of the patient, in turn, helps phenomenally early and accurate diagnosis of prostate cancer and the assessment of the severity of the neoplastic process, said Sergei Suchkov. «For comparison, in the past patients because of the numerous false-positive results without the need of taking a biopsy. They administered an inadequate treatment even for benign forms of tumors that could be left intact», — he explained.

Identification of blood biomarkers such as single transformed cells, helps to assess the cumulative risks of metastasis, to monitor the effectiveness of treatment and to predict relapses and to carry out preclinical diagnosis of latent pre-cancerous condition. This is a new, highly informative and reliable biomarker for the diagnosis and prediction of cancer, is able to predict the survival of patients with metastatic cancer at various stages during treatment.

«In recent years, gaining popularity and biomarkers next generation of a family of so-called microRNAs detectable in plasma in breast cancer, lung cancer, bowel cancer and other cancers. The use of these biomarkers helps the doctor-chemotherapist to determine the sensitivity of the patient to different types of targeted therapies, including the newest combinatorial protocols. This practice is common only in the US and Europe. In Russia, it exists in its infancy,» — said the head of the Department of MEPhI.

Looking for the perfect biomarker

An ideal biomarker, according to experts, should meet a number of criteria depending on how it is used:
(a) it is desirable to determine non-invasive methods, and it needs to point to the existence of the tumour to the onset of clinical symptoms;
(b) it must be sensitive to changes in the tumor process (e.g., response to therapy or surgical vmeshatelstvo);
(C) it should be easy to move from model systems into clinical practice as an interpretable parameter, without any medical advice.

MEPI talked about the role of biomarkers in personalised treatment of cancer© Press-service Mitraszewska scientists have created a universal «designer» drugs rackedla implementation of biomarkers it is necessary to develop the process of validation and to standardize the procedure for preparing biological samples, creating sets of reliable methods for screening and evaluating biomarkers as a strategic participant personalized and precision medicine.

Today in a world of rapidly growing technology market related biomarkers, including cancer. This is affected by the rapid rise of cancer rates of the population, combined with advances in diagnosis and treatment.

«The search for new biomarkers is badly needed, and the scope of such a search should gradually expand, affecting and «silent» (the apparent «outside» to date) region of the genome. It is necessary to develop cooperation of academic and University science, on the one hand, biopharmaceutical and medical diagnostic companies, on the other, engaging in the development of initiatives in venture capital and grant funds,» said Sergei Suchkov.

Thus, according to him, all interest groups should participate in decision-making or define the use of intermediate and final research results. It is necessary for the development of targeted drugs for fundamentally new generations.

https://chelorg.com/2018/07/02/mepi-talked-about-the-role-of-biomarkers-in-personalised-treatment-of...
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