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Biomarker intermediate endpoints and cancer prevention.

F L Meyskens1

  • 1University of California, Irvine, UCI Clinical Cancer Center, Orange 92668.

Journal of the National Cancer Institute. Monographs
|January 11, 1992
PubMed
Summary

Identifying reliable biomarker intermediate endpoints is crucial for cancer chemoprevention trials. These biomarkers can predict cancer risk and serve as surrogates for tumor development, improving trial efficiency and ethical considerations.

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Area of Science:

  • Oncology
  • Biomarker Research
  • Cancer Prevention

Background:

  • Cancer detection is the primary endpoint in chemoprevention trials, but ethical and practical challenges exist.
  • Preneoplasias may prevent cancer development, and cancer incidence can be too low or slow for timely trial results.
  • Current risk assessment methods, like family history, offer limited improvements in trial population size and individual risk prediction.

Purpose of the Study:

  • To explore the utility of biomarker intermediate endpoints in cancer chemoprevention.
  • To identify biomarkers that predict cancer risk or act as surrogates for cancer development.
  • To address the limitations of using cancer detection as the sole endpoint in clinical trials.

Main Methods:

  • Review of existing strategies for risk assessment in chemoprevention.
  • Discussion of the potential of genetic, epigenetic, and histologic features as biomarkers.
  • Emphasis on the need for validation of biomarkers in human models, particularly in the upper aerodigestive system.

Main Results:

  • Biomarker intermediate endpoints offer a viable alternative to cancer detection in chemoprevention trials.
  • Advances in understanding cancer genetics will facilitate the development of novel risk-assessment probes.
  • The upper aerodigestive system presents a promising model for biomarker studies due to accessible tissue and observable carcinogenesis.

Conclusions:

  • Biomarker intermediate endpoints are essential for overcoming feasibility and ethical issues in cancer chemoprevention research.
  • The challenge lies in validating the relevance of numerous potential biomarkers across various specificities of carcinogenesis.
  • Human models, especially in the upper aerodigestive tract, are critical for identifying and verifying effective biomarker intermediate endpoints.

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