Translational Cancer Biomarkers in Surgery: From Molecular Discovery to Clinical Implementation
DOI:
https://doi.org/10.64229/0sx33440Keywords:
Cancer biomarkers, Surgical oncology, Translational medicine, Molecular diagnostics, Clinical decision makingAbstract
Surgery is the most important form of treatment in most solid tumors and cancer is one of the most important causes of cancer-related deaths worldwide. The identification and clinical translation of reliable biomarkers for precision patient stratification and personalised therapeutic decision-making are becoming increasingly important for optimising surgical outcomes. The present review discusses the state-of-the-art of the cancer biomarker field in the context of surgical oncology, highlighting the most recent advances in the discovery of biomarkers based on genomic, transcriptomic, proteomic, metabolomic and integrated multi-omics approaches. Biomarkers are classified as diagnostic, prognostic and predictive based on their utility in clinical practice for early detection of cancer, risk stratification, selection of treatment and postoperative monitoring. New technologies such as liquid biopsy, artificial intelligence, single-cell transcriptomics and spatial omics are paving the way to the discovery of new biomarkers and precision surgical oncology. However, there are still substantial hurdles to overcome, such as standardisation of the assays, analytical and clinical validation, tumour heterogeneity, regulatory approval, cost-effectiveness, and implementing the assays in the various healthcare environments. These barriers to translation are discussed in this review, and are examined critically, with current controversies and limitations identified, and future research needs defined, such as multicenter validation studies, standardised reporting frameworks, the incorporation of a range of advanced multi-omics technologies with artificial intelligence, and the development of clinically actionable biomarker-driven surgical algorithms. Implementing solutions to these challenges will be critical to make biomarker discoveries a reality in the clinic and to advance the goal of better patient outcomes after cancer surgery.
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