Evidence-based biomarkers that measure the potential for therapeutic response and/or toxicity are critical to guide optimal patient care and contextualize the results of immunotherapy clinical trials. Responding to the lack of guidance on biomarker testing in early phase immunotherapy clinical trials, The Society for Immunotherapy of Cancer (SITC) proposes a definition and listing of essential biomarkers recommended for inclusion in all such protocols. These recommendations are based on consensus provided by the SITC Clinical Immuno-Oncology Network (SCION) faculty with input from the SITC Pathology and Biomarker Committees and the JITC readership.
SITC proposes that biomarkers in the essential tier should be included in all relevant trials. Essential biomarkers are selected based on:
- Strong evidence of clinical relevance and/or biological relevance,
- Broad support across tumor types and treatment approaches, and
- High feasibility (i.e. standardized testing methods, routine or readily available testing).
The eligibility tier captures feasible markers that are relevant in specific contexts (e.g., specific immunotherapy targets).
Candidate markers with limited evidence of clinical utility or lacking a well-described, analytically validated assay are relegated to the emergent tier, with the expectation that they will eventually establish their value and move into the essential or eligibility class, or else drop out of consideration. Furthermore, SITC provides criteria for evaluation of promising emergent biomarkers to allow promotion to essential based on sound scientific principles and guided by suitable fiscal support.
Novel biomarkers may render previously essential biomarkers obsolete, triggering removal from the essential list.