A biomarker is any physical characteristic of the human body that can be measured. Your blood pressure is a biomarker. A hemoglobin level is a biomarker. Some biomarkers can be linked to a particular diagnosis, to disease outcomes, or to response to medication or other therapy. In oncology, important biomarkers that can be measured include the DNA, RNA, and protein within a tumor. These biomarkers can be used to make a diagnosis, to predict cancer aggressiveness, or to predict that a particular therapy will be effective.
Which biomarkers are important to measure? Caris measures a comprehensive set of biomarkers to help Oncologists make informed treatment decisions.
To the treating oncologist, clinical utility is paramount in managing the cancer patient. A biomarker with a good track record of clinical validity – i.e. a reliable test – is not enough. As mentioned, biomarker profiling serves three essential functions: confirming what the tumor is (diagnosis); getting an idea of the tumor’s aggressiveness (prognosis); and identifying potential vulnerabilities in the tumor (prediction).
In pathology, evaluating a tumor’s cellular architecture and, if necessary, selecting from amongst established diagnostic markers generally leads to a proper diagnosis. Interrogating a tumor’s underlying biology may confirm a suspected diagnosis – the sarcoma family of tumors serve as classic examples. Although uncommon, a new diagnosis is found after a thorough molecular evaluation of a tumor specimen, sometimes dramatically altering the course of management.
Biomarkers used in prognosis determine a malignancies’ likely course (e.g. odds of recurrence). Should a prognostic biomarker predict for a poor outcome, the treating oncologist may opt for more intensive therapy.
Predictive biomarkers are those which select for a specific medication. In advanced and metastatic NSCLC alone, various biomarkers – EGFR, ALK, ROS1, MET, RET, and PD-L1 – are recommended by the NCCN upon diagnosis for the purpose of treatment decision-making. These results determine whether a patient receives targeted therapy, immunotherapy, and chemotherapy based on testing results.
Each cancer has a unique molecular profile – knowledge which directs the next course of management.
To interrogate these cancer biomarkers, your doctor will need to submit a tumor specimen or bodily fluid to a laboratory that specializes in advanced pathology and molecular profiling services. These testing methods assess biomarkers for the presence or absence of potentially actionable aberrations.
At our laboratory, our comprehensive approach reveals what is happening at the molecular level of a tumor to effect patient care. We incorporate the most current technology and marry them to published clinical studies from academic cancer centers across the globe. We feel this approach provides your doctor invaluable guidance in determining the next course of therapy or, perhaps, consider a novel approach not previously considered.