Biomarkers hold promise in the diagnosis, prognosis and therapeutic stratification of hematopoietic malignancies. These heterogeneous diseases – including multiple myeloma, lymphomas and leukemias – are frequently characterized cytogenetically with diagnoses supported by genetic, immunohistochemical and flow cytometric analyses. Biomarkers offer the hope of early detection as well as tracking disease progression and recurrence. Early detection may help improvesurvival, as it could help identify individuals most at risk for disease development, distinguish aggressive from indolent disease, and track disease progression. In therapeutic stratification, biomarkers potentially allow for patient-specific selection of agents that are likely to be effective and not cause unnecessary toxicity. Notable clinical advances were reported at the 54th Annual American Society for Hematology Annual Conference (December 7-11, 2012; Atlanta, GA), suggesting that through innovative, biomarker-based approaches, better outcomes can be achieved with lower doses of drugs. Additionally, recent progress in the characterization of the molecular genetics of various hematologic malignancies may form the basis for improved patient stratification and future targeted/individualized therapies. Integration of clinical, cytogenetic and molecular data will be indispensible in translating this progress into better outcomes for patients. There is also a need for standardization of the technologies used for clinical assessment of minimal residual disease – enabling detection of lingering disease burden after treatment – and their interpretation. In the future, for treatment of hematologic malignancies to become affordable and value-driven, continued investment in biomarker discovery, elucidation and application of prognostic/predictive biomarkers will be needed. This has potential to identify genetic associations and profiles that can be drugged or targeted, ultimately putting the promise of personalized medicine within reach.
White Paper January 12, 2015