In an era of personalized medicine disease specific biomarkers play an
April 5, 2017
In an era of personalized medicine disease specific biomarkers play an increasing role in the stratification of high-risk patient groups. there have been major improvements in targeted therapies providing new avenues and hope to patients with this devastating disease. This review will focus PTK787 2HCl on most up to date histological serological and molecular biomarkers in malignant melanoma. mutational status. Only patients with mutational status however cannot be used as a diagnostic or prognostic biomarker as mutations are also present in benign naevi and although those melanomas with a mutation are more likely to develop regional metastases there is no evidence of any effect on overall mortality . In 2005 a commentary was released on behalf of the National Malignancy Institute-European Organisation for Research and Treatment of Malignancy (NCI-EORTC) outlining “Reporting Recommendations for Tumour Marker Prognostic Studies (REMARK)”. The overarching aim of these guidelines was to encourage transparent and total reporting of biomarker studies so that appropriate conclusions can be drawn from their results. This document gives guidance on favored methods for data analysis Rabbit polyclonal to PON2. and presentation that allow its goals to be achieved when preparing work for publication thus allowing a more strong comparison to be made between trial results . The standard clinical method for melanoma diagnosis and stratification is based on immunohistochemistry (IHC). As such a large number of potential biomarkers have been assessed using IHC as a readily available and clinically relevant methodology. An extremely comprehensive review that encompasses a wider range of IHC based protein biomarkers in melanoma that can be encompassed in this review was undertaken by Gould Rothberg in 2009 2009  and subsequently updated in 2010 2010 . These meta-analyses revealed 101 proteins that are good candidates for prognostic discrimination in melanoma. These proteins were involved in a range of tumour capabilities such as tissue invasion and metastasis growth signalling and immunocompetence. Regrettably many tumour marker studies have not been reported in a demanding fashion and often lack sufficient information to allow adequate assessment of the quality of the study or applicability of results. Guidelines have been launched PTK787 2HCl to recommend elements and types for presentation with the objectives of facilitating evaluation of the appropriateness PTK787 2HCl and quality of study design methods analyses and improving comparability of results across studies . Five phases of biomarker development have been proposed. These include preclinical exploratory studies (Phase 1) clinical assay development for clinical disease (Phase 2) retrospective longitudinal repository studies (Phase 3) prospective testing studies (Phase 4) and malignancy control studies (Phase 5) . The REMARK guidelines launched a more detailed algorithm in the design and reporting of biomarker development studies . At present no recognized potential biomarker has undergone a large demanding prospective trial with multivariate analysis that would allow it to be fully validated and developed for clinical practice. As such there still remains an acute need for such markers in melanoma. This review aims to outline the current established biomarkers in melanoma as well as reviewing the latest biomarkers of interest and highlighted in the last few years. 2 Established PTK787 2HCl Biomarkers in Melanoma The current international requirements for melanoma disease staging are based on the American Joint Committee on Malignancy (AJCC) 2009 melanoma staging criteria. AJCC combines histological tissue variables clinical characteristics as well as serological markers as prognostic biomarkers in order to stratify patients according to their prognosis. It must be noted that this system is still unable to identify those specific individuals that will develop metastases and that the underlying biological relevance of these markers is still not fully elucidated . 2.1 Breslow Thickness Alexander Breslow was the first person to statement the role of tumour thickness as a biomarker predicting tumour progression . In his initial study of 98 patients; tumour thickness depth of invasion and cross sectional area was.