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. 2016 Apr 27;6:106. doi: 10.3389/fonc.2016.00106

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Copyright © 2016 This work is authored by Elise C. Kohn and S. Percy Ivy on behalf of the U.S. Government and, as regards Dr. Kohn, Dr. Percy and the U.S. Government, is not subject to copyright protection in the United States. Foreign and other copyrights may apply.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Predictive vs. prognostic biomarkers. Prognostic biomarkers (A) have similar change in outcome with therapy that is independent of the biomarker status. Predictive biomarkers (B) have a treatment/outcome interaction, seen in this example as improvement with treatment in biomarker⁺ cases (vertical arrow), with absence of change in the biomarker⁻ cases (horizontal arrow). Biomarkers that may be both prognostic and predictive (C) will shift the biomarker⁺ curve the same or greater if both the prognostic and predictive effects are positive. If one is positive and the other is negative, the outcome may cancel. This is a more complex situation to dissect.