What is lung cancer biomarker testing?
When you undergo a lung cancer screening, there’s a lot of terminology thrown around that can sometimes feel confusing. Biomarker testing, for example, sounds like a phrase straight out of a science fiction novel, but this test has been incredibly important in ensuring that treatment for certain lung cancers is the most effective it can be.
What is biomarker testing, and how does it help with lung cancer treatment? Pulmonary and critical care physician Nicholas Fuerst, MD, offered explanations and answers to help you feel more at ease during your cancer testing and treatment.
What is biomarker testing?
“To boil it down, biomarker testing is a test run on either the patient’s blood or tumor tissue that looks for very specific genetic changes of the cancer cells,” said Dr. Fuerst. “These biomarker combinations can be unique to an individual’s tumor, and they can help us guide treatment.”
Biomarker testing helps determine if there are specific genetic mutations that are causing the cancer growth. If those mutations are present, they can be targeted by certain medications that work well against those mutations.
While often compared to genetic testing, they’re looking at very different things. Genetic testing looks through your genetic makeup to figure out what sorts of inherited concerns may have been passed down from your parents. Biomarker testing is performed explicitly after a cancer diagnosis, searching within the cancerous cells for genetic mutations that could help decide on the best treatments for your unique cancer growth.
Why is biomarker testing done? What benefit does it provide?
“Not every lung cancer is the same genetically, and it’s just not effective to treat them all the same,” said Dr. Fuerst. “Biomarker testing helps us tailor the treatment more to your specific cancer and your body.”
In some cases, the patient may be a candidate for immunotherapy or targeted gene therapy, which can sometimes be more effective and tolerable than traditional chemotherapy alone. Also, by profiling the tumors, you may find that you could potentially be a candidate for clinical trials focusing on that specific mutation, which could offer options of treatment that aren’t otherwise available.
Do all people who potentially have lung cancer undergo biomarker testing?
“Yes, people with certain lung cancers, notably non-small cell lung cancer (NSCLC), will have biomarker testing performed to help clarify treatment recommendations,” said Dr. Fuerst.
How is biomarker testing done?
During the initial procedure used to diagnose lung cancer, most often through a bronchoscopy, tumor tissue is obtained. This involves the doctor using a thin tube inserted through the nose or mouth to look directly at your lungs and airways, as well as to take a tissue sample. Oncologists can request the biomarker testing be performed directly on the tissue sample obtained.
Sometimes, the amount or quality of tissue obtained is inadequate, and the oncologist can order a blood test that can look for these biomarkers on tumor DNA that is circulating in the blood stream. The blood test has a lower sensitivity to detect the mutations than the tissue test, so it is not considered as good a cancer “screening” test or sufficient in making a cancer diagnosis.
My biomarker testing results are confusing. How should I speak to my doctor about them?
“Biomarker testing can be quite confusing initially, but it’s very important to the modern-day treatment regimen used to treat non-small cell lung cancer, in particular,” said Dr. Fuerst. “Because of the importance of biomarker testing and the potential benefits of the treatment options, I find it’s incredibly useful to have this information in hand before final decisions are made on a treatment regimen, as it can significantly impact treatment recommendations and outcomes.”
While receiving your test results quickly can feel like having more control over your medical care, it can also lead to unnecessary distress. Make sure you discuss your test results with your oncologist. Your treatment team wants you to be fully informed when it comes to your care.
“I would also add one more piece of advice,” said Dr. Fuerst. “Tumor genetics can change over time. Just because a certain treatment is unavailable when you were first diagnosed doesn’t mean you will never be able to access that form of treatment. Additionally, there are always countless clinical trials ongoing studying how we can use biomarkers to guide future targeted therapy for lung cancer, so treatment recommendations do change over time.”
Thanks to advancements in technology and new treatment options, along with more advanced screening and testing techniques becoming available, survival rates for lung cancer have been steadily increasing since the 1990s.
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