Mon Jul 05 2021
Biomarkers for Cancer: An Overview
Cancer is a deadly disease associated with a high mortality rate. Most forms of cancers have a high recurrence rate and can cause significant morbidity in a patient’s life. Screening and early diagnosis of cancer are vital for prompt treatment onset and good prognosis. Cancer biomarkers are crucial for the timely detection of malignant disease. Biomarkers for cancer are also instrumental in monitoring treatment progression in cancer patients. This article will discuss the currently used biomarkers for cancer detection in clinical practice and provide an overview of the efficacy of suPAR as a biomarker for cancer.
Which Biomarkers Exist for Cancer?
Cancer biomarkers can be grouped into two categories based on their usage1 :
- Predictive biomarkers: These biomarkers predict response to specific therapeutic interventions and assess the effectiveness of a particular cancer therapy.
- Prognostic biomarkers: These biomarkers aim to inform the physicians the risk of clinical outcomes of a cancerous condition, such as disease recurrence or progression.
The currently available cancer biomarkers and their clinical uses are listed as follows2 :
- Prostate-specific antigen (PSA): Used for screening, diagnosis and monitoring of prostate cancer and benign prostate hyperplasia (BPH).
- Carbohydrate antigen 125 (CA125): Used for diagnosis and prognosis of ovarian cancer. This biomarker is also used to detect recurrence rate and for therapeutic management of ovarian cancer.
- Carcinoembryonic antigen (CEA): Used for screening hepatic (liver) metastases. It is also used for assessing prognosis, detecting recurrence rate, and monitoring therapy of colorectal cancer.
- Carbohydrate antigen 15-3 (CA 15-3): Used to monitor breast cancer therapy.
- Estrogen, progesterone receptors (ER and PgR): Used for stratification and selection of breast cancer patients for endocrine therapy.
- HER2: Used to monitor trastuzumab therapy in breast cancer patients.
- Carbohydrate antigen 27.29 (CA 27.29): Used for monitoring breast cancer therapy.
- Human chorionic gonadotrophin-B (HCG-B): Used for diagnosis, staging, recurrence detection, and monitoring therapy of testicular cancer.
- Alfa-fetoprotein: Used for diagnosis, recurrence detection, and monitoring therapy of hepatocellular carcinoma (liver cancer).
- Calcitonin: Used for diagnosis and monitoring therapy of medullary carcinoma of the thyroid gland.
- Thyroglobulin: Used for monitoring thyroid cancer treatment.
- CA 19-9: Used for monitoring therapy of pancreatic cancer.
- Nuclear matrix protein 22 (NMP-22): Used for screening, monitoring and determining prognosis of bladder cancer.
- Prostate cancer antigen 3 (PCA3): Used for prognostic purposes in 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 et.al. Cancer biomarker discovery and validation. Translational Cancer Research. 2015. Vol 4: 3.
2. Hala et.al. Cancer Biomarkers: Role of Biomarkers in Medicine, Mu Wang and Frank A. Witzmann. IntechOpen Books. 2016. https://www.intechopen.com/books/role-of-biomarkers-in-medicine/cancer-biomarkers
3. Chounta et.al. 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 et.al. 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 et.al. 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 et.al. Increased plasma soluble uPAR level is a risk marker of respiratory cancer in initially cancer-free individuals. Cancer Epidemiology, Biomarkers & Prevention. 2011.
8. Loosen et.al. Soluble urokinase plasminogen activator receptor (suPAR) as a novel biomarker in patients undergoing resection of pancreatic adenocarcinoma. Journal of Clinical Oncology. 2019.