Tag Archive for: mutational status

Navigating Lung Cancer Biomarker Testing | Challenges and Solutions for Timely Access

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Navigating Lung Cancer Biomarker Testing | Challenges and Solutions for Timely Access from Patient Empowerment Network on Vimeo.

To achieve accurate biomarker data for lung cancer patients, what are challenges and solutions? Expert Dr. Joshua Sabari from NYU Langone discusses challenges that can arise during the biomarker testing process, solutions to overcome the challenges, and proactive advice to help ensure optimal patient care. 

[ACT]IVATION TIP

“…not only know your mutation, but speak up for yourself. Speak up for your loved one. Make sure that the correct testing is done and that there is sufficient tissue, both for blood and tissue from the biopsy, to do the correct testing to allow us to potentially match people to the best treatments available.”

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See More from [ACT]IVATED NSCLC Biomarkers

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 Equity in Action | Addressing Biomarker Disparities in Lung Cancer

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Transcript:

Lisa Hatfield:

So, Dr. Sabari, this is a multi-part question here, so I’ll break it down a little bit. What are some of the main challenges in collecting accurate biomarker data, and how can researchers overcome these challenges? And considering the challenges that oncologists face in retrieving testing results at second-line treatment, what technological advancements or procedural changes could streamline the process and ensure timely access to biomarker testing results?

Dr. Joshua Sabari:

So when we talk about biomarker testing, we’re generally talking about testing the tissue, as well as sometimes testing blood or plasma. And it’s important that if you have a good and accurate biopsy with sufficient tissue, that then gives us the ability to select or do the correct biomarker testing. So that’s first and foremost, you know, fine needle aspiration, small aspirations may give us insufficient tissue. You know, whereas if you do a core needle biopsy, whether it be percutaneous through the chest with an image or bronchoscopically through the mouth with a camera, we’re able to get a large sample of tissue.

This will give us the amount of tissue needed to do the correct biomarker testing. We call it next generation sequencing or short for NGS, where we’re able to actually identify the mutations or abnormalities in your DNA. The other type of test we can do is on plasma, where we sometimes call it a liquid biopsy. That’s a simple blood test where, you know, a team will draw about two 10 cc blood tubes, where we’re then able to sequence, you know, DNA in your blood to help identify these alterations.

So having sufficient tissue or having the blood drawn, that’s important. 

But then also having your physician and your clinician and healthcare team order the appropriate test. You know, it’s unfortunate. A lot of folks that I see in my practice have not had adequate testing done in the frontline setting. Oftentimes, clinicians will be in a rush to start systemic treatment, both because patients are symptomatic, but also because they want to get going with treatment for patients. So, you know, stopping your physician, your team and saying, hey, what is my mutational profile? What is my mutational status is an extremely important discussion to have with your clinician. So a lot of times we only see this being done in the second-line setting.

So having that information up front could allow you and your family members to be matched to the best possible therapy. Now, if you’ve started a treatment and you don’t have genetic testing or molecular testing done in the front line, I would then have it done in the second-line setting. So one of my activation tips here is not only know your mutation, but speak up for yourself. Speak up for your loved one. Make sure that the correct testing is done and that there is sufficient tissue, both for blood and tissue from the biopsy, to do the correct testing to allow us to potentially match people to the best treatments available.

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Key Considerations When Making Prostate Cancer Treatment Decisions

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Key Considerations When Making Prostate Cancer Treatment Decisions from Patient Empowerment Network on Vimeo.

What considerations are vital when making prostate cancer treatment decisions? Expert Dr. Tomasz Beer shares important factors that impact advanced prostate cancer care.

Dr. Tomasz Beer is Deputy Director at OHSU Knight Cancer Institute. Learn more here: https://www.ohsu.edu/people/tomasz-m-beer-md-facp.

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Transcript:

Katherine:          

What are the considerations when choosing treatment for advanced prostate cancer?

Dr. Beer:                     

Well, here, the considerations in advanced prostate cancer are first and foremost, what is the best treatment for this particular individual, right?

That’s what we want to do, and by the best treatment, I mean most effective with the fewest side effects, protecting their quality of life. But that’s an oversimplification. In reality, to arrive at what the best treatment is, we need to really understand quite a bit about the patient’s cancer. Sometimes it’s mutational status, as we discussed earlier, but also, the way it’s presenting, how aggressively it’s growing, is it involving the liver or lungs, or is it only in the bones, is it fast, is it slow.

And then the other thing that is extremely important is the patient’s health, other medical conditions. Some treatments are really more difficult to give when somebody has cardiovascular disease, or diabetes, or nerve damage, or other causes preexisting to the cancer treatment.

So, those kinds of things which we call comorbidities in the medical arena are really important in refining the risk-benefit ratio for each treatment. And finally, and critically, what prior treatments patients have received, that’s a major consideration. We obviously wouldn’t be using the same treatments again in many patients. There are exceptions to that, but for the most part, if a treatment’s failed once, it’s not likely to be of great benefit.

So, we integrate the cancer presentation, perhaps genomics in some situations, patient-specific health conditions, patient’s prior treatments, and then of course, patient’s values and personal priorities and what’s most important to them. And from all of that information, we take a look at the available portfolio and suggest one or two options, which we as physicians, based on our experience, expertise, and the knowledge of the literature, believe that fit most closely and are most likely to be successful.