Cancer Biomarkers: Clinical Aspects and Laboratory Determination

Cancer Biomarkers: Clinical Aspects and Laboratory Determination

1st Edition - June 7, 2022

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  • Editors: Lakshmi Ramanathan, Martin Fleisher, Michael Duffy
  • Paperback ISBN: 9780128243022
  • eBook ISBN: 9780128243039

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Cancer Biomarkers: Clinical Aspects and Laboratory Determination provides a comprehensive overview of current biomarkers for cancer detection, monitoring and recurrence, focusing on emerging technologies, impacts on the field, and selected biomarkers currently used in clinical practice. The content highlights current laboratory tests used in the management of adult and pediatric cancer patients. In addition, it investigates the role of Circulating Tumor Cells and circulating tumor DNA as biomarkers in cancer management as well as cytokines in monitoring response to CAR T therapies. This title is a perfect reference for clinical pathologists, laboratory scientists, medical technologists, physicians specializing in oncology, internal medicine, family practice and transplant medicine, resident physicians, medical students, nurse practitioners and clinical chemists.

Key Features

  • Provides insights into the overall complexity that the cancer patient presents and how laboratory tests are used in the management of care
  • Discusses current and new technologies applicable to cancer biomarker evaluation, including the use of non-traditional specimens like saliva, fluids and uterine lavage
  • Reviews current trends in liquid biopsy and cancer biomarkers
  • Provides a roadmap for bringing new technologies and markers from the bench to the bedside in the quest for finding the ideal tumor marker


Clinical pathologists; laboratory scientists; medical technologists; physicians specializing in oncology, internal medicine, family practice and transplant medicine; resident physicians; medical students; nurse practitioners, clinical chemists

Table of Contents

  • Cover image
  • Title page
  • Table of Contents
  • Copyright
  • List of contributors
  • Preface
  • Acknowledgments
  • Chapter 1. Overview of traditional and nontraditional tumor markers
  • Abstract
  • Objectives
  • 1.1 Introduction
  • 1.2 Definition and characteristics of tumor markers
  • 1.3 Utilization of serum tumor markers in malignant and benign tumors
  • 1.4 Understand FDA approved and non-FDA approved tumor markers
  • 1.5 Overview of methodologies for measurement of tumor markers
  • 1.6 Laboratory technologies for tumor marker measurement
  • 1.7 Technical limitations of immunoassays
  • 1.8 High-pressure liquid chromatography mass spectrometry
  • 1.9 Methods for detecting nontraditional and emerging tumor markers
  • 1.10 Summary Points
  • 1.11 Future direction
  • References
  • Chapter 2. Laboratory testing in pediatric cancer patients
  • Abstract
  • Objectives
  • 2.1 Introduction
  • 2.2 Childhood leukemia
  • 2.3 Childhood lymphoma
  • 2.4 Brain and central nervous system tumors (gliomas)
  • 2.5 Neuroblastoma
  • 2.6 Wilms tumor
  • 2.7 Hepatoblastoma
  • 2.8 Germ cell tumors
  • 2.9 Conclusions and future directions
  • 2.10 Summary points
  • References
  • Chapter 3. Challenges with common laboratory tests in the adult cancer patient
  • Abstract
  • Objectives
  • 3.1 Introduction
  • 3.2 The effect of inflammation on laboratory results
  • 3.3 Interferences produced by cancer
  • 3.4 Physiologic changes due to cancer treatment
  • 3.5 Preanalytical issues
  • 3.6 Analytical issues
  • 3.7 Postanalytical issues
  • 3.8 Conclusion and future directions
  • 3.9 Summary points
  • References
  • Chapter 4. Thyroglobulin and thyroid cancer
  • Abstract
  • Objectives
  • 4.1 Introduction
  • 4.2 Thyroid nodule evaluation and the limited role of preoperative serum thyroglobulin measurements
  • 4.3 Postoperative evaluation of differentiated thyroid cancer
  • 4.4 Thyroglobulin in the monitoring of differentiated thyroid cancer
  • 4.5 Utilization of thyroglobulin autoantibodies as surrogate marker
  • 4.6 The measurement of thyroglobulin by immunoassays and the challenge of autoantibodies
  • 4.7 Thyroglobulin measurement by mass spectrometry using peptide immunoaffinity enrichment
  • 4.8 Thyroglobulin measurement by mass spectrometry—toward harmonization
  • 4.9 Thyroglobulin measurement by mass spectrometry—other challenges
  • 4.10 Practical application of thyroglobulin measurement by mass spectrometry: a suggested approach
  • 4.11 Thyroglobulin measurement—future directions
  • 4.12 Conclusion
  • 4.13 Summary points
  • References
  • Further reading
  • Chapter 5. PSA: role in screening and monitoring patients with prostate cancer
  • Abstract
  • Objectives
  • 5.1 Introduction
  • 5.2 PSA: physiological function and analytical assay
  • 5.3 PSA screening trials
  • 5.4 Baseline PSA studies and long-term risk of lethal prostate cancer
  • 5.5 PSA as a tumor marker and screening tool for prostate cancer and recommendations from national guideline groups
  • 5.6 PSA-related blood biomarkers to improve the specificity of PSA and rule out the need for prostate biopsy
  • 5.7 Methods of detecting PSA
  • 5.8 Role of PSA in monitoring disease recurrence and progression
  • 5.9 Conclusions and future directions
  • Conflict of interest declaration
  • References
  • Chapter 6. Monoclonal gammopathy detection and current technologies
  • Abstract
  • Objectives
  • 6.1 Introduction
  • 6.2 Monoclonal gammopathies
  • 6.3 Current technologies for M-protein detection
  • 6.4 New and emerging technologies for M-protein detection
  • 6.5 Summary Points
  • 6.6 Future directions
  • References
  • Chapter 7. Liquid biopsy as a cancer biomarker-potential, and challenges
  • Abstract
  • Objectives
  • 7.1 Introduction
  • 7.2 Clinical utility of liquid biomarkers
  • 7.3 Clinical development and validation of liquid biomarkers
  • 7.4 Circulating tumor cells
  • 7.5 Circulating tumor DNA
  • 7.6 Conclusion
  • 7.7 Summary points and future directions
  • Further readings
  • References
  • Chapter 8. Chimeric antigen receptor T cells and management of toxicities: implications of biomarkers
  • Abstract
  • Objectives
  • 8.1 Introduction
  • 8.2 Construct and manufacturing process of CD19 chimeric antigen receptor T cells
  • 8.3 Immune-mediated toxicities of CD19 chimeric antigen receptor T-cell therapy
  • 8.4 Clinical application of biomarkers in CD19 chimeric antigen receptor T-cell therapy
  • 8.5 Predictive biomarkers of severe chimeric antigen receptor and immune effector cell-associated neurotoxicity syndrome
  • 8.6 Predictive biomarkers for hematologic toxicities
  • 8.7 Predictive biomarkers for hemophagocytic lymphohistiocytosis and macrophage activation syndrome
  • 8.8 Predictive models for chimeric antigen receptor and immune effector cell-associated neurotoxicity syndrome
  • 8.9 Biomarkers of chimeric antigen receptor T-cell response, outcome, and treatment failure
  • 8.10 Summary points and future directions
  • Disclosures
  • Acknowledgment
  • References
  • Chapter 9. Cerebrospinal fluid circulating tumor cells for diagnosis, response evaluation, and molecular profiling of leptomeningeal metastases from solid tumors
  • Abstract
  • Objective
  • 9.1 Introduction
  • 9.2 Rare cell capture technology as a diagnostic tool for leptomeningeal metastases
  • 9.3 Clinical Laboratory Improvement Act certification
  • 9.4 Additional applications of cerebrospinal fluid circulating tumor cells and other techniques
  • 9.5 Limitations of the CellSearch platform
  • 9.6 Summary Points
  • 9.7 Future directions
  • References
  • Chapter 10. Saliva as a matrix for measurement of cancer biomarkers
  • Abstract
  • Objectives
  • 10.1 Introduction
  • 10.2 Saliva production and secretion
  • 10.3 Transport of biomolecules from the blood into saliva
  • 10.4 Saliva collection methods and saliva types
  • 10.5 Salivary biomarkers for cancer
  • 10.6 Oral microbiome as a biomarker for cancer
  • 10.7 Salivary metabolites for cancer diagnosis
  • 10.8 Limitations of salivary biomarkers
  • 10.9 Summary Points
  • 10.10 Future perspective
  • Acknowledgments
  • References
  • Chapter 11. Emerging technologies in cancer detection
  • Abstract
  • Objectives
  • 11.1 Introduction
  • 11.2 Electrochemical techniques
  • 11.3 Optical techniques
  • 11.4 Magnetic techniques
  • 11.5 Mass spectrometry
  • 11.6 Mechanical and synthetic techniques
  • 11.7 Data analytics
  • 11.8 Summary Points
  • 11.9 Conclusions and future directions
  • References
  • Chapter 12. Oncometabolites and their role in cancer
  • Abstract
  • Objectives
  • 12.1 Introduction
  • 12.2 Oncometabolites and their associated cancers
  • 12.3 In vitro profiling and measurement of oncometabolites
  • 12.4 Omics approaches to metabolite profiling in cancers
  • 12.5 Imaging for oncometabolites
  • 12.6 Recent innovations in oncometabolomics
  • 12.7 Measuring oncometabolites D-2-hydroxyglutarate and L-2-hydroxyglutarate in the clinical laboratory
  • 12.8 Conclusion and future directions
  • 12.9 Summary points
  • References
  • Chapter 13. Circulating cancer biomarkers: current status and future prospects
  • Abstract
  • Objectives
  • 13.1 Introduction
  • 13.2 Clinical uses of established circulating protein biomarkers
  • 13.3 Future trends in cancer biomarker applications and ongoing research
  • 13.4 Conclusion and future directions
  • 13.5 Summary points
  • Acknowledgment
  • Conflict of interest
  • References
  • Index

Product details

  • No. of pages: 474
  • Language: English
  • Copyright: © Elsevier 2022
  • Published: June 7, 2022
  • Imprint: Elsevier
  • Paperback ISBN: 9780128243022
  • eBook ISBN: 9780128243039

About the Editors

Lakshmi Ramanathan

Dr. Lakshmi V. Ramanathan is the Service Chief of Clinical Chemistry in the Department of Laboratory Medicine at Memorial Sloan Kettering Cancer Center in New York City. Prior to joining Memorial Sloan Kettering Cancer Center, Dr. Ramanathan was the Director of Chemistry at Mount Sinai Medical Center in New York City. She is a licensed laboratory Director in the State of New York. Dr. Ramanathan obtained her PhD in Nutritional Biochemistry and Metabolism at Massachusetts Institute of Technology in Cambridge, Massachusetts, USA. Her interests include laboratory automation and biomarkers in cancer diagnostics as well as teaching Clinical Pathology and Laboratory Medicine to residents and fellows. She is very active in the American Association of Clinical Chemistry, is the founding Chair of the Tumor Markers Cancer Diagnostics Division and was the past chair of the New York metro section.

Affiliations and Expertise

Service Chief of Clinical Chemistry in the Department of Laboratory Medicine at Memorial Sloan Kettering Cancer Center in New York City, USA

Martin Fleisher

Dr. Martin Fleisher is currently Emeritus in the Department of Laboratory Medicine at the Memorial Sloan-Kettering Cancer Center. During his tenure at MSKCC he served as Chief and Director of the Clinical Chemistry Laboratory and Chair of the Department of Clinical Laboratories. Dr. Fleisher is a licensed Laboratory Director in the States of New York. Dr. Fleisher received his B.A. degree from Harper College, State University of New York (now Binghamton University). He was awarded a Masters and Doctorate degrees in Biochemistry, with honors, from New York University. As a graduate fellow at the New York University School of Medicine in the Departments of Biochemistry and Physiology, his doctoral research focused on protein chemistry and specifically enzymology. He is considered an expert in biomarker assay development and validation. Dr. Fleisher has over 200 publications, including five chapters, on his research, and has edited a book on the Clinical Biochemistry of Cancer. He holds five US patents.

Affiliations and Expertise

Emeritus, Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center

Michael Duffy

Professor Duffy who is based at St Vincent’s University Hospital, Dublin and University College Dublin, has an international reputation for his research in cancer biomarkers. He has published over 250 papers on this topic, including articles in high impact journals such as Lancet, BMJ, J Natl Cancer Instit, Cancer Res, Clin Cancer Res, Ann Oncol and Clin Chem. Professor Duffy received his BSc (Hons) from the National University of Ireland at Galway (Ireland) and his PhD from the University of Manchester (UK). In 2012, Professor Duffy was the recipient of the 2012 Abbott Award of the International Society of Oncology and BioMarkers (ISOBM). Other awards received by Professor Duffy include the St Luke’s Medal Lecture, the Conway Review Medal Lecture and the Lifetime Achievement Award of the Royal Academy of Medicine in Ireland and the National Committee for Biochemistry Award Medal Lecture of the Royal Irish Academy.

Affiliations and Expertise

St Vincent’s University Hospital, Dublin and University College Dublin, Ireland

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