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Select biomarkers for tumors of the gastrointestinal tract: present and future
Angela N Bartley1, Stanley R Hamilton
1From Molecular Diagnostics, Department of Pathology, St. Joseph Mercy Hospital, Ypsilanti, Michigan (Dr Bartley); and the Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas (Dr Hamilton).
Context:
Advances in molecular biomarkers of the gastrointestinal tract have contributed to a decline in the incidence of and mortality from diseases of the gastrointestinal tract. The discovery and clinical validation of new biomarkers are important to personalized cancer therapy, and numerous clinical trials are currently ongoing to help identify individualized therapy affecting these biomarkers and molecular mechanisms they represent. Distinct molecular pathways leading to cancers of the colorectum, esophagus, stomach, small bowel, and pancreas have been identified. Using biomarkers in these pathways to direct patient care, including selection of proper molecular testing for identification of actionable mutations and reporting the results of these biomarkers to guide clinicians and genetic counselors, is paramount.
Objective:
To examine and review select clinically actionable biomarkers of the colon, esophagus, stomach, small bowel, and pancreas, including present and future biomarkers with relevant clinical trials.
Data Sources:
Extensive literature review and practical and consultation experience of the authors.
Conclusions:
Although numerous biomarkers have been identified and are currently guiding patient therapy, few have shown evidence of clinical utility in the management of patients with gastrointestinal cancers. Inconsistent results and discordant proposed algorithms for testing were identified throughout the literature; however, the potential for biomarkers to improve outcomes for patients with gastrointestinal cancer remains high. Continued advances through high-quality studies are needed.
Insights
Molecular biomarkers for gastrointestinal (GI) cancers are advancing personalized therapy. While promising, current biomarkers show limited clinical utility, necessitating further research for improved patient outcomes.
Area of Science:
- Gastroenterology
- Oncology
- Molecular Biology
Background:
- Molecular biomarkers have improved outcomes for gastrointestinal (GI) diseases.
- Identifying new biomarkers is crucial for personalized cancer therapy.
- Distinct molecular pathways are known for GI cancers.
Purpose of the Study:
- To review clinically actionable biomarkers for colon, esophagus, stomach, small bowel, and pancreas cancers.
- To examine current and future biomarkers.
- To include relevant clinical trials for GI cancer biomarkers.
Main Methods:
- Extensive literature review.
- Authors' practical and consultation experience.
Main Results:
- Numerous biomarkers are identified and guide therapy.
- Few biomarkers demonstrate clear clinical utility in GI cancer management.
- Inconsistent results and testing algorithms were found.
Conclusions:
- Biomarkers hold high potential for improving GI cancer patient outcomes.
- Continued high-quality studies are essential for biomarker advancement.
- Further research is needed to establish clinical utility.
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