The Power of Biomarkers in Cancer Diagnosis and Precision Treatment

Biomarkers have long been considered a key factor in improving patient care, reducing healthcare costs, and protecting patients from ineffective and potentially toxic treatments. With the advancement of medical technology, what can biomarkers do for our health, and how can they help patients with accurate diagnosis and treatment? The following are some cases of the use of biomarkers for diagnosis and treatment shared by Huang Yiwu, the chief physician of the Oncology Department of Mamorie Hospital Cancer Center, so that everyone can better understand the practical application of biomarkers.

First of all, let’s understand what role biomarker detection can play in the process of diagnosing and treating cancer.

Every tumor has different characteristics, and some tumors are divided into many subtypes. Treatment options vary for different subtypes. Biomarker detection can help us find specific mutation targets, and let us know whether we can use targeted drugs for treatment——distinguish the subtype of tumors in time, and then we can find the most suitable treatment plan and achieve the best results. The clinical effect, to avoid unnecessary side effects.

The previous biomarker test was to check the blood, and the effect was relatively limited. The current biomarker detection can perform molecular biological detection on tumor tissue, and clearly distinguish the biological characteristics of each patient’s tumor.

Secondly, biomarkers can also assist in regular inspections after treatment to determine the probability of recurrence.

Current treatments include biological testing for the vast majority of tumors—especially advanced tumors. Early tumors may not recur after radical treatment. However, for middle- and late-stage tumors, it is necessary to understand the different gene mutations and special biological characteristics of the tumor. This information can be used to detect recurrence in time and understand how to take the most appropriate treatment once recurrence occurs.

Biomarker test reverses late-stage lung cancer symptoms in man

Lung cancer has the highest mortality rate among all cancers. At present, the application of the development of biology in the medical field has made great progress, and the detection of biomarkers can also effectively improve the survival rate of patients.

Let me give you an example. In 2015, I had a patient who was 36 years old at the time with a more advanced form of malignant lymphoma. At that time, I used chemotherapy for him, plus a targeted drug called Ritasun. After six courses of treatment, the tumor completely disappeared.

However, during the regular review six months later, many nodules were found in the patient’s lungs. At that time, I first thought that the lymphoma had recurred, so I performed a puncture for the patient, took a little tumor cells, and found out a new tumor—lung adenocarcinoma.

At that time, the tumor had spread to both lungs, and surgery and radiotherapy were no longer suitable. Then, we did some biologically targeted tests, that is, molecular genetic tests, and found that this patient had an ALK fusion gene mutation.

Lung adenocarcinoma has been found to have more than a dozen different gene mutations, and different drugs can be used to treat these gene mutations.Advanced patients with ALK mutations cannot undergo surgery, but it has been found that if targeted drugs are used alone, the 5-year survival rate of patients can reach more than 60%[1]. In other words, most patients can control their condition very well only by taking medicine at home.

At that time, there was a drug that specifically targeted this gene mutation called Crizotinib. After two or three months of taking the medicine, the patient was checked again and found that the tumors had all disappeared. After that, the patient continued to take the medicine for more than 4 years, during which his life was very normal and he was not affected in any way.

Four years later, the patient said that he began to have headaches. After testing, it was found that the tumor had gradually developed drug resistance and metastasized in the brain. Therefore, we replaced it with a third-generation drug that specifically targets ALK (LK) gene fusion—Alecinix (Alecinix) for treatment. After taking the medicine, the tumors in the brain also disappeared. Generally, brain tumors require electrotherapy and even surgery. But this patient did not need such treatment, and the appropriate drugs can control the tumor well. The patient is now 43 years old, and his work and life have not been affected.

Treatment of advanced rectal cancer without chemotherapy and without surgery

Previously, doctors did not know that many drugs were ineffective for many patients. Now, through biological targeted testing, we can know whether a specific targeted drug antibody treatment is effective for a patient.

Another case was a 30-year-old woman who unfortunately suffered from advanced rectal cancer. Although the tumor can be cured, it generally requires radiotherapy, chemotherapy, and surgery, and it is usually necessary to carry a colostomy bag for life after surgery, which will affect the quality of life to some extent.

After the patient’s diagnosis, we also conducted biomarker testing to find the most suitable therapy, and found that the patient had a special gene mutation-high microsatellite instability (MSI-high). Generally speaking, patients with this mutation have a very good effect on immunotherapy, and advanced patients can be treated without chemotherapy, and the disease can be well controlled. Therefore, the patient began to receive immunotherapy against PD-1 antibodies every three weeks. When she was examined six months later, it was found that the young patient no longer required surgery, radiotherapy or chemotherapy—the tumor in her body had completely disappeared. In more than a year of observation so far, the tumor has not recurred.

How to perform biomarker testing

Tumors can develop in many organs of the body. When diagnosing cancer, you first need to figure out the type of tumor, because the same gene mutation may occur in different tumors. After knowing the type of tumor, the next step of molecular target marker detection will be done accordingly to provide more information and better guide treatment.

There are two parts to biomarker testing: checking blood, secretions, or extracting tumor tissue-most experienced doctors will not make patients feel too uncomfortable during the testing process.

In addition, if the detection method is not sensitive enough, or if there is no specific mutation in the first tumor sample, it may not be detected at one time. Therefore, repeated inspections may be required.

Biomarker detection is another milestone in medical technology, which can be used as a powerful auxiliary force in the diagnosis and precise treatment of cancer. If you or your family members unfortunately get a tumor, please do not panic. Because with the development of medicine, many tumors can be cured or controlled for a long time.

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Editor in charge: Li Fan