Promoting ProGRP
Xchange newsletter – Autumn 2008
Pro-gastrin-releasing peptide (ProGRP) is a novel biomarker that can assist clinicians in diagnosing and monitoring small cell lung cancer (SCLC), an aggressive cancer that often multiplies quickly and spreads rapidly throughout the body. Since entering into a licensing agreement with Fujirebio in May 2006, Abbott’s goal is to bring the potential of ProGRP for improving patient outcomes through earlier diagnosis, to a larger audience.
In July 2008 a survey was conducted at the 1st International Lung Cancer Conference (ILCC) in Liverpool. The objectives of the survey team were to present the concept of the ProGRP biomarker in the treatment of SCLC and gauge current awareness of biomarker technologies, and ProGRP in particular, with oncologists.
Marjo Catsberg, product manager for immunoassays, Europe, attended the meeting. She said, “The survey found that differential diagnosis and early detection of lung cancer are the greatest challenges for diagnosis. 25% of the oncologists we talked to already use biomarkers for diagnosis and monitoring, although the concept of ProGRP as a marker for SCLC is still relatively unknown. Those respondents who had read articles about the benefits of ProGRP agreed that it shows promise as a valuable marker in SCLC.”
“The survey was very helpful,” Marjo continued. “It confirmed that guidelines and recommendations, clinical value, time to results and cost were all important selection criteria for diagnostic tools from the oncologists’ perspective.”
Marjo concluded by saying, “ProGRP has already influenced how small cell lung cancer is diagnosed and managed by physicians in Japan where it has been shown to be more effective than current tests. It is important that we continue to increase awareness of this novel marker in Europe so that patients can benefit from this advanced technology.”
Diagnosing SCLC
Small cell lung cancer (SCLC) yields cells with neuroendocrine properties that release a hormone into the circulating blood in response to a neural stimulus. Pro-gastrin-releasing peptide (ProGRP), neuron specific enolase (NSE) and chromogranin A (CGA) are therefore putative serum markers for this disease1. ProGRP has shown promise in preliminary studies, demonstrating a sensitivity relationship (AUC-ROC) significantly greater than those calculated using NSE and CGA1.
ProGRP is the unprocessed form of Gastrin-releasing peptide (GRP), a regulatory human peptide, which controls numerous functions of the gastrointestinal and central nervous systems, including release of gastrointestinal hormones, smooth muscle cell contraction, and epithelial cell proliferation2.
Biomarkers
The aim of diagnostic and prognostic biomarkers is to identify patients with a condition prior to major organ damage and to predict the risks of further complications.
The potential for earlier diagnosis and better risk stratification has wide-ranging implications for many conditions and support for the use of novel biomarkers is increasing throughout the field of diagnostic medicine. The concept of treating every patient showing similar symptoms in the same way is becoming obsolete with the continued expansion of treatment options. The future lies towards more personalised diagnoses and treatments and multiple biomarker strategies support this goal.
As well as ProGRP, Abbott has several other novel biomarkers released or in development: Myeloperoxidase, MPO, (cardiac disease), Cystatin C and NGAL (renal), and HE4 (ovarian cancer) and PlGF/sFlt (pre-eclampsia during pregnancy).
References
- Lamy, P.J. et al, Pro-gastrin-releasing peptide, neuron specific enolase and chromogranin A as
serum markers of small cell lung cancer. Lung Cancer, 2002, 29;3 - Merali Z, et al, Role of bombesin-related peptides in the control of food intake. Neuropeptides, 2000, 33(5)
