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Published on: July 25, 2020
Clinical Trials in Precision Oncology
Susan M Mockus1, Sara E Patterson2, Cara Statz2
1The Jackson Laboratory for Genomic Medicine, Farmington, CT; susan.mockus@jax.org.
Background:
Availability of genomic information used in the management of cancer treatment has outpaced both regulatory and reimbursement efforts. Many types of clinical trials are underway to validate the utility of emerging genome-based biomarkers for diagnostic, prognostic, and predictive applications. Clinical trials are a key source of evidence required for US Food and Drug Administration approval of therapies and companion diagnostics and for establishing the acceptance criteria for reimbursement.
Content:
Determining the eligibility of patients for molecular-based clinical trials and the interpretation of data emerging from clinical trials is significantly hampered by 2 primary factors: the lack of specific reporting standards for biomarkers in clinical trials and the lack of adherence to official gene and variant naming standards. Clinical trial registries need specifics on the mutation required for enrollment as opposed to allowing a generic mutation entry such as, "EGFR mutation." The use of clinical trials data in bioinformatics analysis and reporting is also gated by the lack of robust, state of the art programmatic access support. An initiative is needed to develop community standards for clinical trial descriptions and outcome reporting that are modeled after similar efforts in the genomics research community.
Summary:
Systematic implementation of reporting standards is needed to insure consistency and specificity of biomarker data, which will in turn enable better comparison and assessment of clinical trial outcomes across multiple studies. Reporting standards will facilitate improved identification of relevant clinical trials, aggregation and comparison of information across independent trials, and programmatic access to clinical trials databases.
Insights
Standardized reporting for cancer biomarkers in clinical trials is crucial. Implementing these standards will improve data consistency, trial comparison, and patient eligibility for genomic-based cancer treatments.
Area of Science:
- Genomic medicine
- Clinical trial design
- Biomarker research
Background:
- Genomic information in cancer treatment is advancing rapidly, outpacing regulatory and reimbursement frameworks.
- Clinical trials are essential for validating genome-based biomarkers for cancer diagnosis, prognosis, and treatment prediction.
- Current regulatory and reimbursement pathways rely heavily on evidence generated from clinical trials.
Purpose of the Study:
- To highlight the challenges in utilizing genomic information from clinical trials.
- To advocate for the development and implementation of community standards for clinical trial reporting.
- To improve the consistency, specificity, and accessibility of biomarker data in clinical trials.
Main Methods:
- The study identifies key factors hindering the use of clinical trial data: lack of specific reporting standards for biomarkers and inconsistent adherence to gene/variant naming conventions.
- It emphasizes the need for detailed mutation information in trial registries, moving beyond generic entries.
- The need for robust programmatic access to clinical trial databases is also highlighted.
Main Results:
- Lack of standardized reporting and naming conventions for biomarkers significantly hampers patient eligibility for molecular-based clinical trials.
- Inconsistent data standards impede bioinformatics analysis and reporting of clinical trial outcomes.
- Current clinical trial registries lack the specificity required for precise patient enrollment and data interpretation.
Conclusions:
- Systematic implementation of reporting standards is essential for consistent and specific biomarker data.
- Standardized reporting will enable better comparison and assessment of clinical trial outcomes across studies.
- Improved standards will facilitate trial identification, data aggregation, and programmatic access to clinical trial databases.
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