The great advances in treatment of breast and hemato- logic cancers are based on agents developed through a precise understanding of the biology of the biomarker being targeted. We have yet to approach this in the field of brain cancer, but we are making progress.
Most of the methods described here are still used to some extent in biomarker discovery. Each has its advantages and its drawbacks. Following the discov- ery of novel biomarkers using the newer techniques, older techniques will continue to be applied to specific molecules in order to fully characterize their role and to develop specific therapies. However, it is clear that the overall trend in the field of cancer biomarker discovery is towards large-scale, unbiased genomic studies.
This increase in scale also refers to the inclusion of multiple research groups in diverse institutions.
We can generate more statistical power for our stud- ies by combining tumor specimens from more than one tissue bank, and by amplifying other institutional resources. This sort of collaboration will advance the field of biomarker research much more rapidly and
effectively than anything done by a single research group in one institution. We have always believed that more can be done if researchers in different institutions work together. The power of numbers, both com- putationally and humanly speaking, will be increas- ingly applied to the search for biomarkers in decades to come.
The biologic, histologic, and clinical heterogeneity of human brain tumors, particularly those of glial ori- gin, has been emphasized repeatedly in brain tumor studies. This means that a single gene or small groups of genes can never fully characterize their behav- ior. The idea that tumors are best characterized by multiple rather than single biomarkers has been dis- cussed in relation to surface markers and genes, but the advent of large-scale genomic analysis takes this to a new level, potentially allowing the development of molecular tumor signatures that include hundreds of genes. High-throughput analysis of tumor mRNA, DNA, protein expression and epigenetic events permit the more rapidly identification of novel markers, and provide a more complete picture of individual tumors.
Brain tumor biomarkers are already being used diag- nostically and therapeutically; new approaches will include the use of biomarkers to reliably individu- alize the diagnosis and therapy of patients’ tumors, allowing us finally to overcome the problem of glioma heterogeneity.
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