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Prognostic and predictive factors revisited.

Daniel F Hayes1

  • 1Breast Oncology Program, University of Michigan Comprehensive Cancer Center, CCGC 6312, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA. hayesdf@umich.edu

Breast (Edinburgh, Scotland)
|October 22, 2005
PubMed
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Identifying reliable prognostic factors is crucial for cancer treatment. While standard markers like tumor size and lymph node status are used, new methods like gene expression signatures show promise but require further validation.

Area of Science:

  • Oncology
  • Biomarker Discovery

Background:

  • Standard prognostic factors in cancer include clinical staging, lymph node status, and tumor size.
  • Tumor grade and lymphatic invasion are moderately predictive but suffer from poor reproducibility.
  • Hormone receptor status and HER-2 amplification are key for selecting specific therapies.

Purpose of the Study:

  • To review established and emerging prognostic and predictive factors in cancer.
  • To highlight promising new markers and their limitations.
  • To emphasize the need for rigorous validation of novel biomarkers.

Main Methods:

  • Review of existing literature on cancer prognostic and predictive factors.
  • Analysis of standard clinical and pathological markers.
  • Evaluation of emerging biomarkers such as bone marrow metastases, UPA/PAI-1 expression, and gene expression signatures.

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Main Results:

  • Established factors like staging and lymph node status remain important.
  • Novel markers including bone marrow metastasis detection, UPA/PAI-1, and gene signatures show potential.
  • Significant caveats exist regarding the validation and application of new technologies.

Conclusions:

  • New technologies offer promising avenues for personalized cancer prognosis and therapy selection.
  • Few novel biomarkers have Level of Evidence I validation.
  • Further prospective, well-designed studies are essential to overcome confounding factors and ensure reliable clinical utility.