Cancer Biomarkers
: Opportunities and Challenges

Ann-Lii Cheng, M.D., Ph.D.
Department of Oncology, National Taiwan University Hospital

We are moving into a new era in which physicians make treatment choices based primarily on the specific characteristics of individual patients and their tumors.  Cancer biomarkers are the key to the success of this endeavor.  However, implementation of the knowledge of cancer biomarkers in our daily practice is not an easy task.  First, the reliability of the technics that we commonly use to do the analyses of cancer biomarkers may not completely reliable.  For example, warm ischemia of the resected tissues, as well as aging of the formalin-fixed paraffin-embedded block slides, significantly jeopardize the interpretation of immunohistochemisty, c-DNA microarray, and proteomic assays.  Second, the cost, workload, and wortflow needed to do the complete items of biomarkers may be a daunting task in many parts of the world.  A comprehensive and prospective solution of this difficult situation can only be reached by the collaboration of the academic societies, the regulatory authorities, the third-party reimbursement organizations, the pharmaceutical companies, and the patient advocates.  Third, the apparent ethnic and geographic differences of many of the cancer biomarkers have put further pressure on the application of the knowledge developed from any single part of the world.  The importance and significance of individual cancer biomarker may not be extrapolated from one region, or one ethnicity, to another.  A comparison between Eastern and Western countries of the pertinent cancer biomarkers will be reviewed and discussed in this lecture.