Mon Jul 05 2021


Cancer, a deadly disease, has a high mortality and recurrence rate, causing significant morbidity. Early screening and diagnosis are key to starting treatment promptly and improving outcomes. Biomarkers play a vital role in detecting cancer early and monitoring treatment progress. This article explores the biomarkers used in clinical practice for cancer detection and evaluates suPAR’s effectiveness as a cancer biomarker.

Which Biomarkers Exist for Cancer?

Cancer biomarkers fall into two categories based on their function:

  1. Predictive biomarkers identify which therapies will work best for a patient and evaluate the effectiveness of a cancer treatment.
  2. Prognostic biomarkers help doctors assess a patient’s cancer outcome risks, like disease recurrence or progression.

Here are the main cancer biomarkers and their clinical applications:

  • Prostate-specific antigen (PSA): Screens, diagnoses, and monitors prostate cancer and benign prostate hyperplasia (BPH).
  • Carbohydrate antigen 125 (CA125): Diagnoses and prognoses ovarian cancer, detects recurrence, and manages treatment.
  • Carcinoembryonic antigen (CEA): Screens for liver metastases, assesses colorectal cancer prognosis, detects recurrence, and monitors treatment.
  • Carbohydrate antigen 15-3 (CA 15-3): Monitors breast cancer treatment.
  • Estrogen and progesterone receptors (ER and PgR): Selects breast cancer patients for endocrine therapy.
  • HER2: Monitors trastuzumab therapy in breast cancer patients.
  • Carbohydrate antigen 27.29 (CA 27.29): Monitors breast cancer treatment.
  • Human chorionic gonadotrophin-B (HCG-B): Diagnoses, stages, detects recurrence, and monitors testicular cancer treatment.
  • Alfa-fetoprotein: Diagnoses, detects recurrence, and monitors hepatocellular carcinoma (liver cancer) treatment.
  • Calcitonin: Diagnoses and monitors medullary thyroid carcinoma treatment.
  • Thyroglobulin: Monitors thyroid cancer treatment.
  • CA 19-9: Monitors pancreatic cancer treatment.
  • Nuclear matrix protein 22 (NMP-22): Screens, monitors, and determines bladder cancer prognosis.
  • Prostate cancer antigen 3 (PCA3): Provides prognostic information for prostate cancer patients.

Multiple studies support the strong association between suPAR and different types of cancer

suPAR as a Biomarker for Cancer

In cancerous diseases, suPAR is expressed on the cancer cells. Multiple studies support the strong association between suPAR and different types of cancer. The important research studies are listed as follows:

  • In 2015, a study published in Liver International reported that the specificity and negative predictive value of suPAR make it a potential screening tool for the early detection of hepatocellular carcinoma in patients with chronic liver disorders3.
  • A study published in Clin Appl Thromb Hemost in 2003 reported significantly elevated serum suPAR levels in association with advanced small-cell lung cancer4.
  • In 2014, a study conducted on patients with advanced alimentary tract carcinoma reported high levels of suPAR. The study also found that highest suPAR levels can be detected in advanced disease with remote metastases5 .
  • A study conducted in 2015 and published in the International Journal of Cancer reported high levels of suPAR in metastatic colorectal cancer patients. The study also found that circulating suPAR levels would be higher in patients who do not respond to cetuximab treatment than in patients who respond. This finding supports the predictive value of suPAR in oncology6 .
  • Elevated suPAR levels are associated with increased risk of incident respiratory cancer. These findings published in the Cancer Epidemiology, Biomarkers & Prevention in 2011 also reported that suPAR could be used for evaluation in cancer risk algorithms7.
  • As per a 2019 study published in Journal of Clinical Oncology, circulating suPAR represents a novel prognostic marker in pancreatic adenocarcinoma patients undergoing tumor resection8 .

1. Goossens Cancer biomarker discovery and validation. Translational Cancer Research. 2015. Vol 4: 3.
2. Hala Cancer Biomarkers: Role of Biomarkers in Medicine, Mu Wang and Frank A. Witzmann. IntechOpen Books. 2016.
3. Chounta Serum soluble urokinase plasminogen activator receptor as a screening test for the early diagnosis of hepatocellular carcinoma. Liver International. 2015. 35(2): 601-7.
4. Cobos E, Jumper C, Lox C. Pretreatment determination of the serum urokinase plasminogen activator and its soluble receptor in advanced small-cell lung cancer or non-small-cell lung cancer. 2003. 9(3): 241-6.
5. Usnarska-Zubkiewicz Soluble urokinase-type plasminogen activator receptor and ferritin concentration in patients with advanced alimentary tract carcinoma. Relationship to localization, surgical treatment and the stage of the disease—preliminary report. Adv Clin Exp Med. 2014. 23(6).
6. Tarpgaard Intact and cleaved plasma soluble urokinase receptor in patients with metastatic colorectal cancer treated with oxaliplatin with or without cetuximab. International Journal of Cancer. 2015. Vol 137: Issue 10.
7. Langkilde Increased plasma soluble uPAR level is a risk marker of respiratory cancer in initially cancer-free individuals. Cancer Epidemiology, Biomarkers & Prevention. 2011.
8. Loosen Soluble urokinase plasminogen activator receptor (suPAR) as a novel biomarker in patients undergoing resection of pancreatic adenocarcinoma. Journal of Clinical Oncology. 2019.


published suPAR studies in leading medical journals

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