Challenges and methodology in the incorporation of biomarkers in cancer clinical trials

tBiomarkers can be used to establish more homogeneous groups using the genetic makeup of the tumourto inform the selection of treatment for each individual patient. However, proper preclinical work andstringent validation are needed before taking forward biomarkers into confirmatory studies. Despitethe challenges, incorporation of biomarkers into clinical trials could better target appropriate patients,and potentially be lifesaving. The authors conducted a systematic review to describe marker-based andadaptive design methodology for their integration in clinical trials, and to further describe the associatedpractical challenges. Studies published between 1990 to November 2015 were searched on PubMed.Titles, abstracts and full text articles were reviewed to identify relevant studies. Of the 4438 studiesexamined, 57 studies were included. The authors conclude that the proposed approaches may readilyhelp researchers to design biomarker trials, but novel approaches are still needed.