Best Practices to Define, Care for Lung Cancer

A lung cancer diagnosis can bring along many emotions and questions. Assembling the right care team and creating a treatment plan designed uniquely for you is important to get you on the right track.

One of the first things to understand is that not all lung cancers are the same. Comprehensive biomarker testing can identify specific mutations, or genetic drivers, in your cancer called biomarkers. These mutations cause cancer to grow and spread in different ways.

Comprehensive biomarker testing is used for people living with non-small cell lung cancer (NSCLC) to determine the presence of particular mutations or proteins in tumors. It's the first step in precision medicine and helps ensure a patient gets matched to the right treatment at the right time based on the cancer's biomarker status.

To be comprehensive, biomarker testing must test for all biomarkers that are recommended for your type and stage of NSCLC, based on the most current clinical guidelines.

The results of these tests help determine whether any of the U.S. Food and Drug Administration-approved NSCLC targeted therapies or a particular immunotherapy drug is right for you as part of the treatment plan. Sometimes a new treatment being tested through a clinical trial may be recommended based on which biomarker is found in the cancer. Comprehensive biomarker testing is most often used to plan treatments for advanced-stage NSCLC.

What Steps Should be Taken to Complete Comprehensive Biomarker Testing?

• Talk: Knowing your biomarkers can help your health care team treat your unique type of NSCLC. The first step is to talk to your healthcare team about comprehensive biomarker testing so you don't miss any potentially crucial information or treatment options. It is important to ask for comprehensive biomarker testing so your doctor tests for all recommended biomarkers. You'll also want to explore whether comprehensive biomarker testing is covered by your private insurance, Medicare or Medicaid plan.
• Test: Your medical team will test for all recommended biomarkers that could be causing your NSCLC to grow and spread. Comprehensive biomarker testing results can take four weeks or longer, but they can help your health care team understand more about your specific type of cancer.
• Treat: Comprehensive biomarker testing results can help inform your individualized treatment plan and provide information necessary for your health care team to determine treatment options specific to your cancer type.

How is Comprehensive Biomarker Testing Done?

Tissue biopsies are the only way to confirm a diagnosis of lung cancer; they are also the standard way to detect driver mutations. There are many different biopsy techniques that can be used to obtain the tumor tissue.

After the tumor tissue is collected, it is sent to a laboratory for testing. In comprehensive biomarker testing, driver mutations in multiple genes are tested for at the same time, rather than one mutation at a time, including not only the ones with approved treatments, but also other known driver mutations.

This is because some of the driver mutations without currently approved treatments may have treatments being tested now or in the near future. Testing positive for a biomarker that currently does not have an approved treatment may make you eligible for a future treatment option or an available clinical trial.

Comprehensive biomarker testing results are analyzed by a pathologist and recorded in a pathology report. It's recommended to get a copy of your pathology report for your own information and have it available to show other doctors, if necessary.