To be able to detect very early tumors, or even premalignant lesions, a diagnostic screening test must be very sensitive and specific. One promising approach to the early detection of cancer is to look, not for proteins secreted by the cancer, but for an antibody immune response to cancer. The advantage of using antibody immunity as an early marker of cancer is that the immune system can respond to immunogenic proteins at low levels that would not be detectable by direct protein screening. In addition, the immune system can potentially detect subtle alterations in proteins when they become aberrantly expressed or mutated in cancer. Serum antibodies to tumor associated proteins have been shown to be useful biomarkers for a variety of cancers.

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Recent advances in protein array technology that allows for simultaneous evaluation of serum antibody responses to thousands of proteins immobilized on chips has revolutionized the field of serum antibody profiling. Moreover, screening patient serum against cDNA expression libraries has also proven to be a high throughput method of tumor specific antibody identification. Using combinatorial approaches for biomarker discovery, we aim to define antibody panels that would be useful in the diagnosis of many common cancers. We have made substantial progress in identifying an immunologic signature in breast, ovarian, and colon cancers.

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