Biomarker Testing in Lung Cancer - Episode 8

Undergoing Genetic Testing for Non-Small Cell Lung Cancer

Allison Collins reflects on the genetic testing she underwent after receiving a non-small cell lung cancer diagnosis and describes the treatment options presented to her at that time.

Vamsidhar Velcheti, M.D.: Unfortunately, from the MRI [magnetic resonance imaging], it did look like the cancer had spread outside of the lung to the brain. What happened next, Allison? I understand you had a bronchoscopy and you had a biopsy done.

Allison Collins: Yes. After I had the MRI and the bronchoscopy, she [the specialist] did genetic testing on the tumor. First they went ahead and they got me situated to do stereotactic radiation to my brain. Two to three weeks I had to wait for my genetic testing to come back. The whole time it was awful waiting because I’m like, “Oh, I have cancer. I want to go ahead and get started. It’s probably spreading some more.” He [the doctor] had to wait until all of the tests came back, and then they scheduled me to go back in. He told me then that I had KRAS G12C. I didn’t know what it meant. He explained it as an on and off switch. I still didn’t know what he was talking about. I had high PD-L1 [programmed death-ligand 1 expression], it was 100%. Tumor mutation burden, that was high. Different things. Basically, none of it really made sense to me, so I was like, “Well, what do you think? What should I do? Am I able to do anything?”

He provided me with three options. He said that I could do chemotherapy, which he said with the type of cancer that I had, he didn’t see the best of results with chemotherapy. Or I could do single immunotherapy or double immunotherapy. The double immunotherapy at the time was still in clinical trials. Between my husband and my doctor, I asked them both, “What would you do if you were in my shoes?” Because at that time I had just turned 40 and my youngest child was 12. I chose double immunotherapy.

Vamsidhar Velcheti, M.D.: Certainly I can imagine how stressful it would be navigating all this information. So much information being thrown at you, you’ve never heard these words before. You don’t know what chemotherapy is, let alone immunotherapy, and you have these KRAS mutations and all the medical jargon. It’s incredibly hard I could imagine.

Transcript edited for clarity.