Diagnostics that not only diagnose cancer, but also help select the appropriate therapy and monitor response are a mainstay in modern oncology, and their use is growing. \u00a0Precision medicine, identifying genetic markers of disease and designing treatments to exploit these, is the essence of \u00a0targeted cancer therapy. \u00a0<\/p>\n
The National cancer Institute has an excellent piece that describes the use of tumor markers<\/a> in cancer diagnosis, treatment, and management – I highly recommend that you read it.<\/p>\n The following is a list of 31 tumor markers tests used routinely in clinical oncology. \u00a0in many instances, the use of certain cancer drugs is limited to instances when these tests are positive. \u00a0For example, Xalkori<\/a> in alk+ lung cancer, Herceptin<\/a> and Kadcyla<\/a> in HER-2\/neu+ breast cancer, Gleevec<\/a> in Bcr\/Abl+ lymphoma, as well as others.<\/p>\n Ova1<\/a> is a panel of 5 different tumor markers to evaluate patients with a pelvic mass (pre-operatively) in order to help to diagnose ovarian cancer. \u00a0The 5 markers are Apolipoprotein A-1,\u00a0\u03b22-microglobulin, CA-125 II, Prealbumin, and Transferrin. \u00a0A single result (score) is provided – the test has a 96% sensitivity and 95% negative predictive value. \u00a0(Interestingly, CA-125 alone is used to monitor the response of patients receiving chemotherapy for ovarian cancer because CA-125 levels track very well with tumor burden even though CA-125 levels may not be very high in patients with ovarian cancer.)<\/p>\n A number of tumor markers are currently being used for a wide range of cancer types. Although most of these can be tested in laboratories that meet standards set by the Clinical Laboratory Improvement Amendments, some cannot be and may therefore be considered experimental. Tumor markers that are currently in common use are listed below.<\/p>\n 1.\u00a0ALK gene<\/a>\u00a0rearrangements<\/p>\n 2.\u00a0Alpha-fetoprotein<\/a>\u00a0(AFP)<\/p>\n 3.\u00a0Beta-2-microglobulin<\/a>\u00a0(B2M)<\/p>\n 4.\u00a0Beta-human chorionic gonadotropin<\/a>\u00a0(Beta-hCG)<\/p>\n 5.\u00a0BCR-ABL fusion gene<\/a><\/p>\n 6.\u00a0BRAF mutation V600E<\/a><\/p>\n 7. CA15-3\/CA27.29<\/p>\n 8. CA19-9<\/p>\n 9.\u00a0CA-125<\/a><\/p>\n 10.\u00a0Calcitonin<\/a><\/p>\n 11.\u00a0Carcinoembryonic antigen<\/a>\u00a0(CEA)<\/p>\n 12.\u00a0CD20<\/a><\/p>\n 13.\u00a0Chromogranin A<\/a>\u00a0(CgA)<\/p>\n 14. Chromosomes 3, 7, 17, and 9p21<\/p>\n 15.\u00a0Cytokeratin<\/a>\u00a0fragments 21-1<\/p>\n 16.\u00a0EGFR<\/a>\u00a0mutation analysis<\/p>\n 17.\u00a0Estrogen receptor<\/a>\u00a0(ER)\/progesterone receptor<\/a>\u00a0(PR)<\/p>\n 18. Fibrin\/fibrinogen<\/p>\n 19. HE4<\/p>\n 20.\u00a0HER2\/neu<\/a><\/p>\n 21. Immunoglobulins<\/p>\n 22. KIT<\/p>\n 23. KRAS mutation analysis<\/p>\n 24.\u00a0Lactate dehydrogenase<\/a><\/p>\n 25. Nuclear matrix protein 22<\/p>\n 26.\u00a0Prostate-specific antigen<\/a>\u00a0(PSA)<\/p>\n 27.\u00a0Thyroglobulin<\/a><\/p>\n\n
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