Don’t overlook the biomarker test for lung cancer

In the last decade, researchers have discovered several genomic mutations that promote lung cancer. The main ones occur in the EGFR, ALK, ROS1, NTRK and BRAF genes, and there are several treatments that work by directly targeting these changes.

In an interview with CURE®, Andrew Ciupek, a PhD in Cancer Biology and clinical research manager at the lung cancer GO2 Foundation, a patient advocacy group, used small cell lung cancer to identify mutations that could target tumors. Check if there is.

cure®: How does genomic testing for non-small cell lung cancer work?
Ciupek: This will be an almost integral part of non-small cell lung cancer treatment, because of the approval of targeted therapies we’ve seen. To know which targeted therapies may be an option for a patient, we first need to know if the patient has one of those mutations or changes. Then the biomarker test begins. Doctors can test the tumor for mutations and changes, and if they are compatible with the targeted therapy, the patient can begin treatment. Without a biomarker test, you may not know if someone is receiving treatment that might work for them. We tell everyone that having this conversation about biomarker testing is really important.

What can I do for people who have already been diagnosed?
Many biomarker tests are performed on tumor tissue, but the tests can be done with blood. This is called a liquid biopsy or blood-based test. Liquid biopsy will assist patients who have already been diagnosed and may have begun treatment. A second biopsy is often difficult or impossible to perform, but blood-based tests can be done at any time during treatment. Retest if someone has never had a biomarker test at the time of diagnosis, or if they have had a previous test, especially if they have selected treatment options that may no longer work It is important to receive Cancer may change, and new changes or mutations that may not have existed before may appear. It’s not just a one-time type.

Can you provide examples of biomarkers and their associated targeted therapies?
The major mutations that we have targeted therapy approved by the Food and Drug Administration include EGFR, ALK, ROS1, NTRK, and BRAF. For biomarker tests
If and when the doctor finds that the patient is EGFR-positive, the patient can start a targeted therapy called Tagrisso (osimertinib). What we have found is that if someone has an EGFR mutation, Tagrisso is a better treatment option than many others. In fact, it is more effective than immunotherapy for patients with EGFR mutations, so knowledge can guide them to better therapeutic pathways.

Are there clinical trials that patients with some of these biomarkers should know about?
Targeted therapies may work for patients for a very long time, but unfortunately the cancer may start to grow again, or the drug may not work as well. Clinical trials are looking at drugs that work after the initial targeted therapies fail. A second reason to consider clinical trials is that there are approved treatments for only a few mutations, but many mutations can occur in non-small cell lung cancer tumors. Many active clinical trials are looking at targeted therapies for mutations or changes that have treatments that have not yet been approved. When someone does a biomarker test and the results come back, there may be changes with no approved therapies, but that may lead them to clinical trials where the therapies are being developed. not.

Dr. Andrew Ciupek is Manager of Clinical Research at the GO2 Foundation for Lung Cancer, led the conduct of research at the Foundation’s Care Continuum Centers of Excellence, and served as a navigator for its therapeutic and clinical trial navigation program, LungMatch. I will fulfill. .. Originally a translational cancer researcher, Ciupek moved to patient advocacy to increase his influence in driving patient-centered research.