The Role of Biomarkers in Alzheimer’s Disease Drug Development

  • Jeffrey CummingsEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1118)


Biomarkers have a key role in Alzheimer’s disease (AD) drug development. Biomarkers can assist in diagnosis, demonstrate target engagement, support disease modification, and monitor for safety. The amyloid (A), tau (T), neurodegeneration (N) Research Framework emphasizes brain imaging and CSF measures relevant to disease diagnosis and staging and can be applied to drug development and clinical trials. Demonstration of target engagement in Phase 2 is critical before advancing a treatment candidate to Phase 3. Trials with biomarker outcomes are shorter and smaller than those required to show clinical benefit and are important to understanding the biological impact of an agent and inform go/no-go decisions. Companion diagnostics are required for safe and effective use of treatments and may emerge in AD drug development programs. Complementary biomarkers inform the use of therapies but are not mandatory for use. Biomarkers promise to de-risk AD drug development, attract sponsors to AD research, and accelerate getting new drugs to those with or at risk for AD.


Alzheimer’s disease Drug development Clinical trials Biomarker Positron-emission tomography Amyloid Tau Neurodegeneration 



J.C. acknowledges funding from the National Institute of General Medical Sciences (Grant: P20GM109025) and support from Keep Memory Alive.

Declaration of Interest: J.C. has provided consultation to Acadia, Avanir, BiOasis Technologies, Biogen, Boehringer-Ingelheim, Bracket, Eisai, Genentech, Grifols, Intracellular Therapies, Kyowa, Lilly, Lundbeck, Medavante, Merck, Nutricia, Otsuka, Pfizer, QR, Resverlogix, Samus, Servier, Suven, Takeda, Toyama, and United Neuroscience companies. J.C. acknowledges the funding from the National Institute of General Medical Sciences (Grant: P20GM109025) and support from Keep Memory Alive.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Cleveland Clinic Lou Ruvo Center for Brain HealthLas VegasUSA

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