Abstract
Interest in precision diagnostics has been fuelled by the concept that early detection of cancer would benefit patients; that is, if detected early, more tumours should be resectable and treatment more efficacious. Serum contains massive amounts of potentially diagnostic information, and affinity proteomics has risen as an accurate approach to decipher this, to generate actionable information that should result in more precise and evidence-based options to manage cancer. To achieve this, we need to move from single to multiplex biomarkers, a so-called signature, that can provide significantly increased diagnostic accuracy. This Opinion article focuses on the progress being made in identifying protein biomarker signatures of clinical utility, using blood-based proteomics.
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Acknowledgements
The critical reading and comments suggested by J. Borrebaeck (University of California, Berkeley, USA) and C. Rose, C. Wingren, S. Ek, and expert bioinformatic guidance by C. Peterson and M. Ohlsson (CREATE Health Translational Cancer Center, Lund University, Sweden) are gratefully acknowledged.
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The author is one of the founders of a start-up diagnostic company in complex diseases.
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Glossary
- Bead-based arrays
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Similar to antibody microarrays but the antibodies are deposited on micro-beads instead of on a planar surface.
- Biomarker velocity
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The change in signal of a biomarker over time.
- Enzyme-linked immunosorbent assay
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(ELISA). A solid-phase immunoassay that measures the interaction between proteins and specific antibodies.
- 510(k)
-
A premarketing submission made to the US Food and Drug Administration (FDA) to demonstrate that the test is safe and effective. If cleared by the FDA, the test can be marketed in the United States.
- Gleason score
-
A score given to a prostate cancer based on its microscopic appearance, whereby a higher Gleason score indicates a more aggressive tumour.
- Antibody microarrays
-
Miniaturized enzyme-linked immunosorbent assay format.
- Laboratory developed tests
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(LDTs). In vitro diagnostic tests that are designed, manufactured and used in a single laboratory and not approved by the US Food and Drug Administration.
- Reverse phase protein arrays
-
Arrays in which protein samples are deposited in micro-scale on a planar surface and probed with specific antibodies.
- Selected reaction monitoring or multiple reaction monitoring
-
(SRM/MRM). Two names for a method used in tandem mass spectrometry to quantitatively target individual proteins or peptides.
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Borrebaeck, C. Precision diagnostics: moving towards protein biomarker signatures of clinical utility in cancer. Nat Rev Cancer 17, 199–204 (2017). https://doi.org/10.1038/nrc.2016.153
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DOI: https://doi.org/10.1038/nrc.2016.153
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