[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-331487-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-331487-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","cancer-biomarker-concentration-changes-during-tumor-progression-commentary","Cancer biomarker concentration changes during tumor progression - Commentary","","Cancer biomarker concentrations commonly rise with disease progression and often track tumor burden or severity. This commentary examines whether serum cancer biomarkers are instead likely to decrease as cancer progresses, using empirical evidence. The discussion argues that declines reported between normal and diseased groups may reflect artifacts or epiphenomena, leading to false discovery rather than true inverse association with tumor load. Clinical implications for validation of “declining” markers are emphasized, urging careful control and patient group verification.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/cancer-biomarker-concentration-changes-during-tumor-progression-commentary/331487/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/cancer-biomarker-concentration-changes-during-tumor-progression-commentary/331487.png","ImageObject",300,407,{"name":42,"@type":43},"Skyler","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-24","2026-09-21",true,{"@type":52,"interactionType":53,"userInteractionCount":33},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What is the central claim about declining serum cancer biomarkers during progression?","Question",{"text":62,"@type":63},"The commentary suggests that decreases in serum cancer biomarkers during progression could be artifacts or epiphenomena, representing false discovery rather than a true inverse relationship with tumor burden.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"Why are most circulating disease biomarkers expected to increase with progression?",{"text":67,"@type":63},"The text states that most circulating biomarker concentrations increase during disease progression, roughly correlating with tumor burden or disease severity.",{"name":69,"@type":60,"acceptedAnswer":70},"How does the PSA example support the proposed interpretation?",{"text":71,"@type":63},"It explains that PSA serum levels rise dramatically because of increased leakage from a large normal reservoir into the systemic circulation, illustrating how concentration changes can reflect reservoir leakage rather than decreased production linked to tumor burden.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},331487,1790488091,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},7,"Healthcare",40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":112,"slug":113},8,30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":111,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":33,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":33,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":123,"preview_page_count":4},2336464648746,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Commentary  \nCancer biomarker concentration changes during tumor progression  \nMiyo K. Chatanaka 1 and Eleftherios P. Diamandis2*  \n1Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada 2*Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada  \nArticle Info Abstract  \nAuthor of correspondence:  \nDr. Eleftherios P. Diamandis, MD, PhD, FRCP(C), FRSC Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada  \nE-mail: [diamandis@lunenfeld.ca](diamandis@lunenfeld.ca)  \nAddress:  \nACDC Lab, Room L6-201, 60 Murray St., Toronto, ON, M5T 3L9, Canada  \nKeywords  \nserum biomarker; cancer biomarker changes; biomarker upregulation; biomarker downregulation; biomarker diagnostics  \nIntroduction  \nMost circulating cancer and other disease biomarker concentrations increase during disease progression, roughly correlating with tumor burden or disease severity. During the biomarker discovery phase, several studies (some published in high-impact journals) report decreases in serum biomarkers at the time of disease diagnosis or during progression (in comparison to control, non-diseased populations) . It is suggested these biomarker decreases between normal and diseased populations may have utility in diagnostics.  \nMethods  \nWe briefly examine ifa serum cancer biomarker concentration is likely to decrease as cancer progresses through empirical data.  \nResults  \nWe propose a simple model, which, if correct, would suggest that in most cases, the biomarker decrease during disease progression could be an artifact or epiphenomenon (thus representing false discovery). Our suggestion is supported by the very few examples of decline of serum biomarkers during cancer development and progression.  \nConclusions  \nThe notion that a serum biomarker concentration could be inversely associated with tumor burden seems to be an epiphenomenon.  \nIntroduction  \nCancer biomarkers have important clinical applications, including screening, diagnosis, prognosis, and monitoring of patients’ therapeutic response. Many contemporary discovery technologies, including genomics, proteomics, metabolomics, and other omics, revolutionized the way we identify and validate new biomarkers. New, and potentially clinically useful biomarkers are still published frequently in the literature. For example, a few candidate serum biomarkers for gliomas have just been published in the journal Science Advances by combining genomics and spatial multidimensional proteomics [1] . Despite the unequivocal progress and technological refinements in discovering new biomarkers, very few, if any, new serological markers have  \neJIFCC2024Vol35No3pp206-209 Page 206  \nentered the clinic in the last 30-40 years. We and others have commented frequently on the failures of new cancer biomarkers to reach the clinic and identified numerous preanalytical, analytical and post-analytical shortcomings [2-4] .  \nAmong different classifications, cancer biomarkers can be grouped into two broad categories: those whose serum concentration is increasing in the presence and progression of malignancy (or as is alternatively stated “their concentration correlates with tumor burden”) and those whose serum concentration presumably “decreases” with tumor presence or progression, in comparison to an appropriate non-diseased population. The first category of tumor markers is far more prevalent than the second one. We are not aware of clinically useful applications of circulating tumor markers which are inversely correlating with tumor burden. In this commentary, we speculate that many circulating tumor markers whose concentration is inversely related to tumor burden (i.e. their serum concentration decreases in comparison to controls when the tumor is first identified or is progressing) likely represent artifacts of the discovery process (false discovery) orepiphenomena. We further advocate that markers that decline with cancer progression should be ","cbCainyh3l9xYw3V","https://ap.wps.com/l/cbCainyh3l9xYw3V","pdf",338241,"English","# Introduction\n# Methods\n# Results\n# Conclusions\n# The PSA paradigm\n# Cancer biomarker during tumor progression","[{\"question\":\"What is the central claim about declining serum cancer biomarkers during progression?\",\"answer\":\"The commentary suggests that decreases in serum cancer biomarkers during progression could be artifacts or epiphenomena, representing false discovery rather than a true inverse relationship with tumor burden.\"},{\"question\":\"Why are most circulating disease biomarkers expected to increase with progression?\",\"answer\":\"The text states that most circulating biomarker concentrations increase during disease progression, roughly correlating with tumor burden or disease severity.\"},{\"question\":\"How does the PSA example support the proposed interpretation?\",\"answer\":\"It explains that PSA serum levels rise dramatically because of increased leakage from a large normal reservoir into the systemic circulation, illustrating how concentration changes can reflect reservoir leakage rather than decreased production linked to tumor burden.\"}]","Cancer biomarker concentration changes during tumor progression - Commentary | PDF",1789993515]