When my healthcare provider (HCP) told me I needed HER2 and BRCA testing, I nodded politely, as if I completely understood everything she was saying. But actually I had no idea what those letters meant.
BRCA and HER2 were just some of the acronym soup thrown into my lap after I was diagnosed with breast cancer.
But I quickly learned that biomarkers like BRCA and HER2 are an important piece of the complex cancer puzzle in understanding and treating the disease.
Cancer Biomarkers and the Importance of Biomarker Testing
Cancer biomarkers are proteins, genes, and other substances that can be measured to reveal details about someone’s cancer or cancer risk.
Cancer varies from person to person at the genetic or protein level, and biomarker testing can help HCPs create personalized treatment plans that target the disease (also known as precision medicine).
“Some biomarkers help healthcare providers identify the exact type or subtype of cancer. Other biomarkers help predict whether a patient is likely to benefit from a specific treatment, such as a targeted drug or immunotherapy,” said medical oncologist Leyre Zubiri Oteiza, MD. “For example, some lung cancers have changes in a gene called EGFR. Patients with these changes can receive drugs that specifically target that mutation, and they often work better than standard chemotherapy.”
A biopsy or blood test for biomarkers can also provide insight into signs of genetic or molecular mutations, how the cancer may behave over time, how aggressive the cancer may be, and/or the risk that the cancer may return. “Equally important, biomarker testing can help us avoid treatments that are unlikely to be effective, save time and reduce unnecessary side effects,” said Zubiri Oteiza.
Read Biomarker 101 >>
Latest actionable biomarkers in cancer treatment
The discovery of cancer-specific biomarkers has changed the landscape of disease treatment.
“In the past, health care providers often chose treatments based on where the cancer started in the body, such as the lung or breast, and what the cancer looked like under a microscope,” said Zubiri Oteiza. “(Currently) some treatments are based on biomarkers rather than where the cancer started.”
Today, there are many biomarkers that are actionable biomarkers. This means that one or more treatments that directly target the biomarker to stop cancer growth are possible. “Thanks to actionable biomarkers, highly effective drugs have been developed that can achieve better results than conventional chemotherapy,” said Zubiri Oteiza.
One example of an actionable biomarker is the NTRK gene fusion. If this biomarker exists, it can be blocked with targeted therapies, regardless of the type of cancer.
“Overall, these advances are making cancer treatment more precise and individualized while helping patients live longer and enjoy a better quality of life,” said Zubiri Oteiza.
Some of the latest actionable cancer biomarkers include:
- Programmed Death Ligand 1 (PD-L1): PD-L1 prevents the immune system from attacking cancer cells in many types of cancer, including bladder, breast, kidney, stomach, cervical, and non-small cell lung cancer.
- Depending on the type of cancer, people with high levels of PD-L1 may respond to immunotherapies called checkpoint inhibitors, which block PD-L1 from binding to T cells (white blood cells that destroy cancer cells) and allow the immune system to kill cancer cells.
- Trophoblast cell surface antigen 2 (TROP2): TROP2 is a biomarker of tumor aggressiveness in various types of cancer, including colon cancer, pancreatic cancer, stomach cancer, breast cancer, and non-small cell lung cancer.
- TROP2 is the target of targeted cancer therapies called antibody-drug conjugates (ADCs).
- Epidermal growth factor receptor (EGFR): Mutated or overexpressed EGFR protein increases cancer progression in lung cancer patients.
- EGFR is a target for a variety of cancer therapies, including tyrosine kinase inhibitors.
- FLT3-Internal Serial Replication (FLT3-ITD): FLT3-ITD is an aggressive genetic mutation that causes rapid cell growth in acute myeloid leukemia and is associated with high relapse rates and poor outcomes.
- The presence of FLT3-ITD guides personalized treatment of FLT3 inhibitors and early stem cell transplantation.
- Human Epidermal Growth Factor Receptor 2 (HER2): Cancers with high amounts of the HER2 protein, or HER2 gene, are called HER2 positive and tend to grow quickly and spread to other parts of the body.
- HER2-targeted therapy is used for HER2-positive cancers of breast, stomach, esophageal, ovarian, pancreatic, and bladder cancer.
How to talk to your health care provider about biomarker testing
Biomarker testing is standard care these days, but it’s important to ask your health care provider what you can expect and what biomarkers they are considering.
“Your health care provider can explain what tests are needed, whether tumor tissue or blood samples are needed, and how the results can help plan treatment,” Zubiri Oteiza said. “During a biopsy, sometimes tests are done on the tumor itself, and sometimes it is done through a blood test called a liquid biopsy.”
It is a good idea to write down any questions you have about biomarker testing and review them with your HCP.
Questions about biomarker testing include:
- Do I need a tissue biopsy or a liquid biopsy?
- What biomarkers are you testing for?
- Are there other tests that can measure the same biomarkers?
- How will we use this information to recommend a treatment plan, and will treatment options change as a result?
- Will my insurance pay for biomarker testing? If not, what financial aid options are there?
“Being informed and asking questions can help you become an active participant in your treatment and explore all available options,” said Zubiri Oteiza.
This training material was created with support from Daiichi, a member of the HealthyWomen Corporate Advisory Board.
From your site article
Related articles on the web
