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Empowering Patients for Important Discussions With the Care Team
Biomarker Testing in Cancer
This video was created by JADPRO in collaboration with Pfizer. Health information provided in the video is for educational purposes only and not intended to replace discussions with your doctor or care team.
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Understanding Biomarker Testing | Table of Contents
Biomarker Testing Basics
Meet a Patient With Lung Cancer
Learning More About the Testing Process
How Do Biomarker Test Results Help Plan Treatment?
Finding Support and Guidance
Biomarker Testing: Putting It All Together
Chapter 5
Chapter 4
Chapter 3
Chapter 2
Chapter 1
IntroDuction
Introduction | Biomarker Testing Basics
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Introduction | Definitions
Precision Medicine
Biomarkers
Biomarker Testing
Somatic Mutation
Germline Mutation
Mutations passed down from parent to child through genes. Identifying these genes helps us understand the patient’s cancer risks, family member cancer risks, and may even help in cancer therapy selection.
Germline Mutations
Mutations that are not inherited, but rather they develop within the tumor. These mutations can give tumor cells a growth advantage or the ability to evade the body’s normal mechanisms of killing bad cells.
A way to look for molecules – often genes or proteins – that can provide information about a person’s cancer. It may help to find the most appropriate treatment for patients.
Molecules produced by the body or a tumor in a person with cancer that can be associated with the growth of the tumor
A form of medicine that uses information about a person’s own genes or proteins to prevent, diagnose, or treat disease
Chapter 1 | Meet a Patient With Lung Cancer
Chapter 1 | Patient Perspective
It may be appropriate to get biomarker testing done multiple times during the course of treatment.
All patients should feel empowered to talk to their oncology team about biomarker testing.
When talking about biomarker testing or the results, it is helpful to have a friend or family member with you. If that is not possible, ask your provider if you can record the conversation.
Looking at information from reliable sources, such as advocacy groups or professional societies, may help you prepare questions for your providers and improve your understanding of biomarker testing.
Chapter 2 | Learning More About the Testing Process
Which of the following is NOT the role of a pathologist?
Helping providers determine which tests to order
Prescribing a cancer therapy that matches a patient's biomarker status
Ensuring that testing is done in a high-quality way
Interpreting the results of biomarker testing
Pathologists play a number of important roles in the biomarker testing process, including helping providers determine the correct test(s) to order, ensuring that the testing is done in a high-quality fashion, and interpreting the results of biomarker testing. Prescribing a therapy that matches the patient’s biomarker status is done by the oncologist or the oncology AP.
Chapter 2 | Test Your Knowledge
Explanation
What is comprehensive biomarker testing?
Testing for a large number of biomarkers at the same time
Testing for biomarkers one at a time until you have a comprehensive report
Testing for 5-10 biomarkers at a time until you find one that is positive
Using multiple tumor samples to test for biomarkers
Comprehensive biomarker testing is testing for a large number of biomarkers at the same time. Most of the time this means “next-generation or high-throughput sequencing”. This is a process where the DNA sequence (partial or complete) of a large number of cancer-related genes in a biopsy sample are examined.
Next-generation sequencing involves processing a biopsy for DNA sequencing, followed by computer processing of the results, then the pathologist’s interpretation of findings. How long does this process take?
Approximately 24-28 hours
Approximately 5-7 days
Approximately 2 weeks
Approximately 1 month
Next-generation sequencing takes up to a couple of weeks to complete. This is because it takes several days to process patient biopsies and to perform the actual DNA sequencing, and then it takes additional days for computers to process the large amount of data generated, and then for pathologists to review and interpret the results when they are ready.
Chapter 3 | How Do Biomarker Test Results Help Plan Treatment?
Picture cancer like a lock that needs to be opened, and treatment like a key. Each person's cancer is unique, like the key for each lock. Having the right key for your lock may help your treatment team choose the best treatment for your particular cancer.
Chapter 3 | Thinking About Biomarkers in a Different Way
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Treatment
Cancer
Biomarker testing can give the team the information to choose the best treatment for you, for the best chance of success.
Chapter 4 | Finding Support and Guidance
I don't know
Complementary
False
True
Biomarker testing may be expensive, but for portions of the cost not covered by insurance, there may be financial assistance available.
Chapter 4 | Test Your Knowledge
If there is an out-of-pocket cost for biomarker testing, there may be financial assistance (through the company that does the testing or from grants) available. Patients should ask their nurse navigator or other members of the care team for help understanding these reimbursement options.
Which resources may exist to help oncology patients if their treatment plan requires frequent travel?
Some private insurance plans offer travel/lodging benefits for patients
Cancer centers may have relationships with hotels to provide rooms at reduced costs.
Cancer centers at times have funds to assist patients with travel costs.
All of the above
Multiple options may exist for cancer patients needing to travel for their treatment. There may be a travel/lodging benefit available through private insurance companies, some cancer centers have relationships with local hotels to provide reduced costs, or the cancer center may have funding available to help patients with travel costs. Patients and their caregivers should talk to the cancer center social worker or nurse navigator to get more information.
What kind of support can a patient navigator provide for patients?
Making connections with a social worker or psychologist
Finding a support group
Clarifying insurance and financial issues
A patient navigator can support patients and their families in many ways: they can coordinate contact with a social worker or psychologist, help locate a support group, clarify the financial and insurance implications of treatment, and assist with other aspects of the cancer journey.
Chapter 5 | Biomarker Testing: Putting It All Together
Chapter 5 | The Team Approach
We have discussed what biomarker testing is, how each member of the clinical care team is involved in your biomarker testing, how your results are interpreted, and how these results influence treatment decisions. Biomarker testing is an important part of precision medicine, and new progress in research will continue to identify even more biomarkers that will help guide decision-making in cancer care.
Ivy Elkins Narjust Florez, MD Amy Malcom, RN, BSN, OCN, RD, LCSW Laura Okolo, DNP, MSN, FNP-BC Daniel E. Sabath, MD, PhD
Many Thanks to Our Contributors
Ms. Elkins has received honoraria from AstraZeneca, Bayer, Blueprint Medicines, Daiichi, Janssen, Mirati, and Merck. Dr. Florez has acted as a consultant and/or advisor for AstraZeneca, DSI, Janssen, Neogenomics, Pfizer, Merck, and Regeneron. Ms. Malcom has no relevant financial relationships to disclose. Dr. Okolo has no relevant financial relationships to disclose. Dr. Sabath has no relevant financial relationships to disclose.
Disclosure
Pfizer Inc. does not control or endorse third-party organizations. The content provided by Pfizer Inc. or these organizations is meant for informational purposes only. It is not meant to replace your doctor’s medical advice.
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Thank you for taking the time to view this educational resource. We hope it was helpful in empowering you to have important discussions about biomarker testing with your treatment team.
