Clinical impact of trace elements as potential biomarkers for diagnosis and prediction of response to systemic treatment in gastrointestinal cancers

Sep 22, 2026

Gastrointestinal cancers are highly prevalent and often remain incurable at advanced stages, creating a need for biomarkers with better diagnostic and relapse-detection performance than conventional tumour markers. Trace elements participate in multiple physiological and metabolic pathways, and disrupted trace-element homeostasis is linked to carcinogenesis and tumour progression. Quantitative, dynamic monitoring of serum trace element levels during systemic therapy and follow-up may help assess treatment efficacy and provide prognostic and predictive value for response.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Trace elements

Conclusions

332 [Radiology and Oncology | Ljubljana | Slovenia | www.radioloncol.com](Radiology and Oncology | Ljubljana | Slovenia | www.radioloncol.com) review Clinical impact of trace elements as potential biomarkers for diagnosis and prediction of response to systemic treatment in gastrointestinal cancers Martina Rebersek1,2 , Radmila Milacic Scancar3,4 , Janez Scancar3,4 , Nezka Hribernik1,2 ¹ Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia ² Medical Faculty, University of Ljubljana, Ljubljana, Slovenia ³ Jožef Stefan Institute, Ljubljana, Slovenia 4 Jožef Stefan International Postgraduate School, Ljubljana, Slovenia Radiol Oncol 2026; 60(3): 332-338. Received 22 January 2026 Accepted 13 April 2026 Corresponence to: Assoc. Prof. Martina Reberšek, M.D., Ph.D., Department of Medical Oncology, Institute of Oncology Ljubljana, Zaloška 2, SI-1000 Ljubljana, [Slovenia. E-mail: mrebersek@onko-i.si](Slovenia. E-mail: mrebersek@onko-i.si). Disclosure: No potential conflicts of interest were disclosed. This is an open access article distributed under the terms of the CC-BY license ([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/)). Background. Gastrointestinal cancers are among the most common malignancies worldwide and, at advanced stages, remain incurable. Currently used biomarkers, such as tumour markers, have limited diagnostic value for early detection and relapse, highlighting the urgent need for more sensitive and specific markers. Trace elements are involved in numerous physiological and metabolic processes, and deregulation of their homeostasis is implicated in the carcinogenesis of various cancers, including gastrointestinal malignancies. Several basic and preclinical studies have identified the importance of trace elements in key biological processes. Recent clinical studies and retrospective analyses suggest that fluctuations in trace element levels may be associated with the development and progression of many cancers. Thus, quantitative and dynamic determination of serum trace element concentrations during treatment and follow-up represents a promising option for monitoring treatment efficacy and disease prognosis. Conclusions. Trace elements may serve as potential prognostic and predictive biomarkers for diagnosis and response to systemic treatment. Key words: trace elements; prognostic and predictive biomarkers; gastrointestinal cancers; systemic therapy Introduction Gastrointestinal (GI) cancers comprise a heterogeneous group of diseases affecting the gastrointestinal tract, including cancers of the oesophagus, stomach, liver, biliary tract, pancreas, small intestine, colorectal (CRC), and anus. These cancers vary in aetiology and clinical management and are among the most prevalent malignancies globally, representing a leading cause of cancer- related death.1 According to the Cancer Registry of the Republic of Slovenia, nearly 3,000 new cases of gastrointestinal cancer are diagnosed annually.2 Prognosis has improved significantly over the past decade due to successful screening programmes, advances in surgical and local ablative techniques, radiation therapy, and systemic treatments for both early and advanced disease. In Slovenia, the incidence of CRC has declined in re- Radiol Oncol 2026; 60(3): 332-338. doi: 10.2478/raon-2026-0023 Rebersek M et al. / Trace elements as potential biomarkers for gastrointestinal cancer 333 cent years, primarily due to increased awareness and preventive screening.2 Despite these advances, cancer remains a leading cause of death worldwide.1 Metastatic GI cancers are still incurable for most patients, with prognosis varying by cancer type, location, and extent of metastases. Pancreatic cancer has the poorest prognosis, while metastatic CRC has a better survival rate, largely due to combined surgical and systemic treatments, especially new systemic treatment possibilities.3,4

FAQs

Why are current gastrointestinal cancer biomarkers considered insufficient?

Conventional serum tumour markers such as CA 19-9 and CEA have limited diagnostic value due to low sensitivity and specificity, especially for early detection and relapse.

What role do trace elements play in the body and in cancer?

Essential trace elements support normal physiology and many biochemical reactions; altered trace-element homeostasis and changes in related protein expression are implicated in cancer development and progression.

How might serum trace element monitoring help during systemic treatment?

Quantitative and dynamic determination of serum trace element concentrations during treatment and follow-up may support monitoring of treatment efficacy and disease prognosis, serving as prognostic and predictive biomarkers.

Sep 22, 2026

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