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 Prognostic markers can help identify patients with aggressive tumors that require further
treatment. While minimizing the risk of over treatment of patients with lethargic disease
that is unlikely to progress.

 Fewer than 10 markers are regularly used as prognostic markers in clinical practice
 Prognostic markers cannot provide individual prognostic information, other established

prognostic factors should be determining (eg, tumor size, grade, and lymph node
involvement).
 Most common prognostic markers used in clinical practice:
1) Cancer antigen 125 (CA125) for ovarian cancer
2) Alpha-fetoprotein (AFP) for Hepatocellular carcinoma
3) Human chorionic gonadotropin (hCG) Germ cell and testicular cancers
4) Prostate-specific antigen (PSA) for Prostate cancer
5) Estrogen level, progesterone and human epidermal growth factor receptor 2 (HER2)
are markers specific to breast cancer patients.
4- Prediction of Treatment Response
 The heterogeneous nature of cancer means that even cancers of the same histological type
may vary widely in response to a particular treatment, and for most cancers only a subset of
patients will respond.
 Predictive markers that can identify those who will respond, so that treatment can be offered
to patients who will benefit and so alternative treatment can be offered to those who will not,
also sparing them unnecessary side effects.
 Most of Predictive markers are measured in tissue rather than serum.
 Several important predictive markers for breast cancer are already well established in
clinical use.
 Estrogen receptor (ER) is probably the most powerful predictive marker in breast cancer
management, both in determining prognosis and in predicting response to hormone therapies
 HER-2 status has also become a routine prognostic and predictive factor in breast cancer
 Progesterone receptor (PR) is also a widely used marker, although its value is less well
established.
5- Monitoring Response During and/or Shortly After Treatment
 The main application of most serum tumor markers is in monitoring the course of disease.
 For most diagnosed cancer patients, it is helpful to measure the relevant tumor marker
pretreatment in order to provide a baseline for subsequent interpretation.