CANCER BIOMARKERS Scientist-Survivor Group 6 Mentor - Ginny Mason Mentor - Dan Gallahan, PhD Howard Brown Vickie Buenger Christine Hodgdon Renee Miles-Foster Kimberly Richardson Marilyn Sapsford

HOW ARE BIOMARKERS USED IN CANCER TREATMENT? Vital measurable functions universal to all people Medium for finding biomarkers → Urine, blood, tissue, stool Biomarkers can be used throughout the cancer care continuum

EXAMPLES OF EXCELLENT BIOMARKERS Melanoma High tumor mutation burden V600E BRAF mutation Prostate cancer PSA Androgen receptor (AR) Colorectal cancer CEA Blood in stool Colon polyps Neuroblastoma Catecholamine To detect, monitor, predict treatment response Medium for finding biomarkers → Urine, blood, tissue, stool

EXAMPLES OF EXCELLENT BIOMARKERS: Gastrointestinal Stromal Tumor (GIST) KIT Ovarian cancer: BRCA ½ mutations Inhibin A/B Lung cancer: TILs, EGFR, ALK, KRAS, PD-1 Breast cancer: HER2 amplification, ER/PR+ BRCA ½ mutations

AN IDEAL BIOMARKER WILL HAVE THE ABILITY TO: Be used via non-invasive & cost-effective techniques Have non-toxic (minimally burdensome) effects Detect disease early Be accurate / precise / sensitive / specific Impact a large portion of a diverse patient population over time Non-invasive & cost-effective → Dog sniffing would be easier than a tissue biopsy Non-toxic → Scans for monitoring the disease can cause secondary cancers because of exposure to radiation Early detection → No reliable screening test for ovarian, pancreatic, pediatric cancers Accuracy → Can answer accurately if cancer is present, and can be sensitive enough to determine classification of cancer and what treatments it will respond to. Large impact → HER2 expression can predict treatment response, but only 20% of breast cancer patients are HER2+

TO IMPROVE THEIR SUCCESS, FUTURE BIOMARKERS MUST BE: Rigorously tested Adequate sample size (quantity, quality) Reliable and replicable Be constantly re-evaluated Go beyond the traditional methods to mine big data Computational, Machine learning, AI Go beyond the traditional mediums Performance status, Psychosocial changes, Immune system responses, Tumor microenvironment Be rigorously tested to meet scientific standards Adequate sample- size, quantity, quality, diversity Reliable and replicable Be constantly re-evaluated as technology & knowledge evolve Go beyond the traditional methods to mine big data Big data does not equal knowledge or meaning, it’s just data Refine these techniques to identify more ideal biomarkers-->Computational learning / Machine learning / Artificial Intelligence Go beyond the traditional mediums Performance status, Psychosocial changes, Immune system responses, Tumor microenvironment, Pain, Cancer stem cells

Team Biomarker thanks you! Our team’s research concluded that biomarkers will change the face of cancer treatment that saves lives.