Advancing Biomarker Development Through Convergent Engagement: Summary Report of the 2nd International Danube Symposium on Biomarker Development, Molecular Imaging and Applied Diagnostics; March 14–16, 2018; Vienna, Austria

Abstract

Here, we report on the outcome of the 2nd International Danube Symposium on advanced biomarker development that was held in Vienna, Austria, in early 2018. During the meeting, cross-speciality participants assessed critical aspects of non-invasive, quantitative biomarker development in view of the need to expand our understanding of disease mechanisms and the definition of appropriate strategies both for molecular diagnostics and personalised therapies. More specifically, panelists addressed the main topics, including the current status of disease characterisation by means of non-invasive imaging, histopathology and liquid biopsies as well as strategies of gaining new understanding of disease formation, modulation and plasticity to largescale molecular imaging as well as integrative multi-platform approaches. Highlights of the 2018 meeting included dedicated sessions on non-invasive disease characterisation, development of disease and therapeutic tailored biomarkers, standardisation and quality measures in biospecimens, new therapeutic approaches and socio-economic challenges of biomarker developments. The scientific programme was accompanied by a roundtable discussion on identification and implementation of sustainable strategies to address the educational needs in the rapidly evolving field of molecular diagnostics. The central theme that emanated from the 2nd Donau Symposium was the importance of the conceptualisation and implementation of a convergent approach towards a disease characterisation beyond lesion-counting Blumpologyf or a cost-effective and patient-centric diagnosis, therapy planning, guidance and monitoring. This involves a judicious choice of diagnostic means, the adoption of clinical decision support systems and, above all, a new way of communication involving all stakeholders across modalities and specialities. Moreover, complex diseases require a comprehensive diagnosis by converging parameters from different disciplines, which will finally yield to a precise therapeutic guidance and outcome prediction. While it is attractive to focus on technical advances alone, it is important to develop a patient-centric approach, thus asking BWhat can we do with our expertise to help patients?K

A Network-Based Mixed Methods Approach to Analyze Current Perspectives on Personalized Oncological Medicine in Austria

“…The idea of overcoming the traditional one-size-fits-all approach by offering individualized care to a patient on the one hand, avoiding late diagnoses, unnecessary treatments, their costs and side effects in non-respondent groups on the other hand is tempting and could lead to an improved allocation of health resources, better outcomes, an increase in patients' quality of life and a reduction of health expenditures, thus leading to purposeful and cost-effective HC strategies and optimized HC systems [2][3][4][5]. Especially in the field of personalized oncological medicine (POM) remarkable progress has been made in recent years, in particular resulting from the use of powerful biomarkers and molecular pathology (MP) methods [5][6][7][8][9]. Despite of all these advances having been made, several translational, ethical, societal and (health) economic challenges with respect to PM have been identified.…”

“…Despite of all these advances having been made, several translational, ethical, societal and (health) economic challenges with respect to PM have been identified. These include the risk of exploding HC costs which might be dedicated to a small group of people only [10], the lack of standardized procedures regarding evidence generation, health economic evaluations, health technology assessments (HTA) and reimbursement processes [9,11,12], the need of new trial designs, in turn leading to ethical challenges [13], the risk of health inequity and data manipulation, the complexity of interpreting sequencing results and decision making both from HC professionals' and patients' perspective and implementation challenges, bringing new PM and MP techniques-such as genomic services-into clinics [14].…”