DPC Cosponsors
"Tumor Markers at the Millennium"
Conference

DPC was proud to be a major sponsor of the conference presented by the University of Texas M. D. Anderson Cancer Center, Houston, Texas, entitled "Tumor Markers at the Millennium." The Center's Herbert A. Fritsche, Ph.D. chaired the conference, which took place February 26 through March 2, 1999 in Santa Barbara, California. More than 60 podium speakers from many countries contributed to an up-to-the-minute assessment of the status of tumor marker utility and recent advances in research.

The conference covered basic concepts of the processes involved in carcinogenesis, cell proliferation, invasion and metastasis; advances in research and biotechnology that have identified biochemical abnormalities leading to the development of tumor markers; and the clinical utility of markers in diagnosis, early detection, and patient management. With regard to diagnosis, presenters assessed cancer risk--particularly genetic risk--and carcinogen exposure, as well as the value of early detection in high-risk groups. For patient management, tumor markers have been used in staging disease, selecting therapy and monitoring response. Attendees agreed that using markers for assessing disease progression or recurrence can be controversial if treatment regimes are unavailable to help these patients.

Dr. Fritsche reminded the participants that much is expected of tumor markers, including detection of disease at an early stage for improved patient quality of life and extended survival. In addition, markers can improve therapy by 1) aiding in the selection of appropriate agents and dosage, often before clinical assessment can be made; and 2) allowing for discontinuation of an ineffective therapy, to avoid subjecting a patient needlessly to toxic side effects. Tumor markers should also help to reduce the cost of patient care and assist in prevention programs.

A number of individual tumor markers or combinations were reported in various cancers including breast, bladder, prostate, colorectal, ovarian and lung cancers. Some major advances have been made in these contexts. It is interesting that only five years ago there were no effective bladder cancer markers, but now several can be used to replace cystoscopy during disease follow-up. Molecular biology techniques are beginning to identify new genes and their products, offering the possibility of new generations of markers in the next century.

During DPC's breakfast session, Lynn Witherspoon, M.D. of Ochsner Clinic, New Orleans, updated his published study of the follow-up of prostate cancer patients treated by radical prostatectomy, with further data generated by the IMMULITE^® Third Generation PSA assay over the past three years. His new data both confirm and extend the original observations. Some of the patients in the group with more rapidly rising PSA are now receiving additional therapy, and some have died. A number of years will still be required before it can be determined whether earlier treatment in response to rising PSA levels can improve clinical outcome.

Eleftherios Diamandis, M.D., Ph.D., FRCPC, of Mount Sinai Hospital, Toronto, presented his data on sensitive PSA measurements in prostate cancer patients treated by prostatectomy; his data agreed closely with Dr. Witherspoon's. In addition, he described much of his published work on sensitive PSA measurements in breast tumor cytosols, nipple aspirates and amniotic fluid, which initiated good discussions. Dr. Diamandis also presented some early data on the use of the ratio of human kallikrein 2 and free PSA to discriminate between benign and malignant prostate tumors.

The concluding statement from Daniel W. Chan, Ph.D., of Johns Hopkins University School of Medicine, Baltimore, Maryland, reminded the participants that in the context of "Tumor Markers at the Millennium, the future of tumor marker testing is now!" It was clear from the presentations that tumor markers have increasing importance in all aspects of diagnosing and treating cancer patients, and that this will improve continually with new developments.

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