Opinion: Low scientific literacy impedes public discussion on cancer biomarkers

I’m pretty sure someone, somewhere had their cancer-curing breakthrough reported in the media this week. Chances are it relates to the identification of some biomarker or other.

Barely a week goes by without the media trumpeting the “discovery” of some remarkable new gene that may unlock a cancer cure or indicates an increased risk for a particular cancer. Unfortunately, most of these discoveries eventually turn out to have no more impact than the media announcement itself.

The reality is that uncontroversial programs that lead to significant long term reductions in cancer mortality seem pretty thin on the ground.

Which is not to downplay the importance of this kind of scientific endeavour. Basic and applied cancer research is vital to improving the detection, treatment and prevention of this tragic disease. It’s more that increasing the level of sophistication in the public dialogue would lay a more rational foundation for public policy.

Consider colorectal cancer as an example.

There is currently significant debate about the breadth, reach and cost effectiveness of the existing faecal screening program. The program was the beneficiary of a major investment in the May Federal Budget.

Let’s leave that debate to one side for the moment and consider what it would take to improve or supplement that program with an effective, gene-based blood test.

While media reports might suggest otherwise, it’s not easy. I can speak from personal experience because we’ve been working on just such a test for the past five years in partnership with CSIRO and Flinders University.

Over that five years we’ve identified a lot of genes that looked promising. Enough to create a lot of excitement, in fact, if our goals were to improve our academic status or to make grand media announcements.

The problem with most of those gene biomarkers, and biomarkers in general, is that they simply fail to live up to their initial promise during the long and difficult process of clinical validation and testing. That’s the problem with researching cancer biomarkers: it’s tough.

While sifting through all these potential candidates, we have – at long odds – identified a small panel of genes that appear to be sensitive for cancer and, more importantly, have survived the gauntlet of downstream clinical testing that converts a “promising” cancer gene into a real and potentially useful blood test.

I’m sure a talented TV producer could build a whole evening current affairs program around this project and our “breakthrough” test. But let’s put our new blood test into context.

The test shows a high level of sensitivity for bowel cancer in a select group of samples drawn from a high-risk population. But there is still a long way to go before this blood based gene test might be broadly available to the community.

The next step is to seek help from other groups and researchers to cast the net more broadly and to see what we can achieve with a large number of tests drawn from the general population. For this reason, we have finally decided it’s time to make our results public.

If the phone rings at Clinical Genomics in response to this announcement, I genuinely hope I will be speaking with others in the scientific community, commercial pathology players, and cancer stakeholders to help us take this to the next level. It is obviously going to require a collaborative approach.

Then again, it might just be a TV producer looking for an early stage “cancer breakthrough” story.

But that would be a real shame.

Dr LaPointe is the CEO of Clinical Genomics, and was previously General Manager and co-founder of Enterix Inc., the developer of the world’s first dedicated faecal based colorectal cancer screening test. Dr LaPointe holds a Ph.D. in Bioinformatics (Flinders University, Australia) and a B.Sc. in Biological Sciences (Florida State University, USA).