Future Oncology-full text: DNA methylation-based fecal biomarkers for the noninvasive screening of GI cancers

"The next obvious question is “Are we there yet?”
The answer is, “Close, if not completely there”. Without any doubt, recent studies have provided tangible evidence that distinct methylation profiles of DNA originating from tumor cells can be effectively used to screen for occult neoplasia. As described earlier, epigenetic biomarkers offer a plethora of distinct advantages over genetic markers, and de novo methylation represents a positive signal that can be readily detected and quantified in the background of unmethylated alleles. Therefore, despite the current enthusiasm and rapid progress in the field, it may be some time before epigenetic biomarkers are routinely employed. In the interim, the burden lies on the basic researchers and clinicians to continue to identify and validate the repertoire of potential fecal DNA-methylation biomarkers. To reap the full benefits of what we have learnt thus far will eventually require the deciphering of a panel of biomarkers that are highly specific, sufficiently robust and facile, inexpensive and ready for the ‘prime-time’ screening of mass populations at risk for GI cancers. None of this may bear the expected results if we fail to educate the population about the perks and the need for screening, break the cultural taboos and overcome the financial roadblocks that are responsible for low compliance rates. Lastly, steps should be taken to design adequate clinical trials and build a business model that can be used for commercialization of newly discovered fecal DNA methylation biomarkers. These efforts will hasten the translation of genomic discoveries into clinical practice in the not-so-distant future."