Predictive and Prognostic Markers
Summary
Predictive and prognostic markers are measurable biological, molecular or cellular features that inform clinical decision-making by forecasting disease course or treatment response. Prognostic markers stratify patients by risk of adverse outcomes—such as recurrence, progression or death—independent of therapy, reflecting tumour biology and host factors. Predictive markers identify those most likely to benefit from a specific intervention, guiding the choice of targeted agents or immunotherapies. Both classes of markers underpin precision oncology, enabling personalised treatment, optimisation of surveillance intensity and avoidance of ineffective or toxic therapies. Their development relies on high-throughput genomic, transcriptomic and proteomic technologies, coupled with rigorous clinical validation. Composite scores—such as inflammation-based indices—and single-gene or protein assays exemplify the diverse platforms that translate into improved risk assessment, therapy selection and patient outcomes across cancer types.
Research from Nature Portfolio
Evidence from a large retrospective cohort of rectal cancer patients undergoing neoadjuvant chemoradiotherapy has reinforced the value of the modified Glasgow Prognostic Score (mGPS) as an independent prognostic marker. Post-treatment assessment showed that patients with elevated mGPS experienced significantly reduced five-year disease-free survival, confirming that persistent systemic inflammation portends poorer outcomes beyond conventional staging.
A foundational systematic review and meta-analysis examined inflammation-based prognostic scores across operable malignancies, demonstrating that elevated neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio and mGPS uniformly predict reduced overall and cancer-specific survival. The consistency of these associations supports routine incorporation of simple blood-derived indices into perioperative and postoperative risk stratification.
Predictive and Prognostic Markers publication trend
The graph below shows the total number of articles in predictive and prognostic markers across all publications each year (not limited to Nature Index journals).
Technical terms
Prognostic marker: A factor that predicts the likely disease outcome irrespective of treatment.
Predictive marker: A factor that indicates the likelihood of response to a specific therapy.
Modified Glasgow Prognostic Score (mGPS): A composite index based on C-reactive protein and albumin levels, reflecting systemic inflammation.
Neutrophil-lymphocyte ratio (NLR): The quotient of blood neutrophil count to lymphocyte count, indicating the balance between innate and adaptive immunity.
Adenosine pathway: An immunosuppressive metabolic cascade in the tumour microenvironment that can undermine anti-tumour immunity.
References
- The modified Glasgow prognostic score is a reliable predictor of oncological outcomes in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. Scientific Reports (2023).
- The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer: Systematic review and meta-analysis. Scientific Reports (2017).
- Evaluation of the inflammation-based modified Glasgow Prognostic Score (mGPS) as a prognostic and predictive biomarker in patients with metastatic colorectal cancer receiving first-line chemotherapy: a post hoc analysis of the randomized phase III XELAVIRI trial (AIO KRK0110). ESMO Open (2024).
- Increased interleukin-6/C-reactive protein levels are associated with the upregulation of the adenosine pathway and serve as potential markers of therapeutic resistance to immune checkpoint inhibitor-based therapies in non-small cell lung cancer. Journal for ImmunoTherapy of Cancer (2023).
- A comprehensive pan-cancer analysis of prognostic value and potential clinical implications of FTH1 in cancer immunotherapy. Cancer Immunology, Immunotherapy (2024).
About these summaries
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