The Role of Tumor Markers for Evaluation the Course of Chemotherapy

Abstract

Of the millions of new cases of cancer worldwide and deaths associated with cancer, a large number of them were breast and gynecological tumors (Molina R et al., 2005). Some tumor markers are fundamental to the workflow in diagnosis, control of therapy and the monitoring of advanced gynecological diseases (Sturgeon CM et al 2010). The biomarker should be absent in healthy people as well as in good conditions and it is released exclusively from specific tumor cells (Duffy MJ et al 2013). Tumor markers are soluble glycoproteins that are found in the blood, urine, or tissues of patients with certain types of cancer. They are typically produced by tumor cells, but in some cases they may be produced by the body in response to malignancy or to certain benign conditions. Tumor markers are not elevated in all cancer patients, particularly patients with early-stage cancer. The various tumor markers differ in their usefulness for screening, diagnosis, prognosis, assessing therapeutic response, and detecting recurrence. Normalization of tumor marker values may indicate cure despite radiographic evidence of persistent disease. In this situation, residual tumor is frequently nonviable. Sometimes, tumor marker values may rise after effective treatment (due to cell lysis), but the increase may not portend treatment failure. A consistent increase in a tumor marker value, combined with lack of clinical improvement, may indicate treatment failure. Residual elevation after definitive treatment usually indicates persistent disease. Many new tumor markers have been discovered since the development of monoclonal antibodies, and most tumor markers are now detected with them. No marker is completely specific. Therefore, diagnostic immunohistochemistry must be used in conjunction with morphologic and clinical findings. [2]Among asymptomatic persons, the biomarker should allow for the examination of early cancer or premalignant disease and in symptomatic patients the biomarker should help in the differential diagnosis of benign and malignant disease. After diagnosis, an ideal biomarker should also be used to estimate the prognosis and predict the most appropriate treatment. For patients receiving systemic therapy, the level of expression should correlate with therapeutic response and tumor burden (Duffy MJ et al 2015). A biomarker should contribute to improving beneficial clinical outcomes such as increased overall survival (OS), progression-free disease survival (PFS) or Abstract: Gynecological tumors, including endometrial, cervical and ovarian cancer, have increased in incidence over time. The widespread introduction of screening programs and advances in diagnostic imaging methods has lead to a progressive increase in gynecological cancer detection. Accurate diagnosis and proper monitoring of disease remain the primary target for a successful treatment. In the last years, knowledge about cancer biomarkers has considerably increased providing great opportunities for improving cancer detection and treatment. In addition, in the last few years there has been an important development of imaging techniques. Nowadays, a multimodal approach including the evaluation of serum tumor biomarkers combined with imaging techniques, seems to be the best strategy for assessing tumor presence, spread, recurrence, and/or the response to treatment in female cancer patients In this review we provide an overview of the application of biomarkers combined with novel imaging methods and highlight their roles in female cancer diagnosis and follow-up.