On Feb. 18, CURE hosted a webinar focused on educating patients on biomarker testing. Here, we highlight key takeaways from our panelists.
With the ever-growing treatment landscape in lung cancer care, biomarker testing’s role has become crucial in a patient’s journey. However, there is still a need to accelerate education around biomarker testing while granting access for all patients who receive a non-small cell lung cancer (NSCLC) diagnosis.
For example,Juanita Segura – who is a patient with NSCLC who shared her story in a video during the webinar – underwent biomarker testing which ultimately changed her treatment plan. “When I initially went to where I had my treatments, a doctor said you need the biomarker testing because that is going to determine if you have a gene mutation,” she explained, adding that, while waiting seven weeks for her pathology report, she started treatment with traditional chemotherapy and radiation.
Juanita was originally treated at a community cancer center; however, she proactively changed centers to pursue biomarker testing. Luckily, for her, she did, because she found out she did in fact have an actionable mutation.
“And then the last day of my treatments, is when I was told I was ALK-positive … It was a great, I'm going to say breakthrough, especially in lung cancer, to be able to go in, get tissue samples of the tumor and send it to the pathology,” she said. “I was happy because I knew that there was treatment. Yes, a diagnosis of lung cancer is devastating, but to find out that I was ALK-positive and possibly meet my granddaughter, which I did, it was absolutely amazing.I was ecstatic. I was happy. I was thankful, and I was so grateful.”
Juanita is still on tarted therapy today, seven years later, as a result of her biomarker testing.
Currently, there are multiple drugs approved by the Food and Drug Administration (FDA) or in trials to evaluate treatment for genomic alterations like ALK, EGFR, ROS1, BRAF V600E, NRTK, MET, KRAS and RET, ultimately improving the prognosis for patients with lung cancer, I-Fen Chang said.
“Essentially, we're starting to move away from this one-size-fits-all approach of treating lung cancer, and really starting to enter an era of personalized medicine,” said Chang, vice president and therapeutic head for Oncology Global Medical at Amgen Oncology.
However, she added, there remains an opportunity to improve education, awareness and access to biomarker testing. “This has been a catalyst to drive our commitment in supporting three particular areas and efforts. This includes increasing awareness around comprehensive biomarker testing, helping ensure that testing is broadly available for patients, and very importantly, ensuring that these results are readily available to help guide treatment decisions between physicians and patients.”
Because of the gap that remains in awareness of biomarker testing – for both patients and providers – Cancer Support Community recently launched an online tool to help patients with lung cancer and their caregivers understand what biomarkers matter for them and why. The goal of the tool is to empower patients to also advocate for themselves when it comes to biomarker testing. “Our online biomarker testing tool can give you customized information. You just have to answer a few questions about the kind and stage of lung cancer that you or your loved one has,” explained Claire Saxton, vice president of Cancer Support Community.
Moreover, the tool provides help at each question (in case a patient or their loved one is unsure of the answer) and also prompts for individuals to learn more. Once all question are answered, individuals receive a customized list of any biomarkers for patients to talk to their cancer care team about. Moreover, if a patient has not yet received testing, the tool offers tips for talking to health care teams about getting comprehensive biomarker testing.
If a patient has their biomarker testing results, they can click to learn more about their particular biomarker, what those results may mean and what treatments may be best for that specific subtype of lung cancer.
With an estimated 80% of patients receiving care in the community setting, versus academic institutions, there may also be an unmet need in ensuring patients are getting biomarker testing. In conjunction with the Association of Community Cancer Centers, LUNGevity is conducting a three-year study to understand the unmet needs from the patient side as well as the challenge from the provider’s side, with a particular focus on underserved communities and ethnic subgroups.
“In an ideal world, this should never sit on a patient's shoulders,” Andrea E. Ferris, president and chief executive officer at LUNGevity, said. “We just want to make sure that information is health-literate, culturally sensitive and linguistically appropriate so that all people, who are diagnosed with lung cancer, can really benefit from the advancements in the treatments.”
Similarly, the American Cancer Society supports a national lung cancer round table, comprised of 150 organizations, with a high priority focused on biomarker testing challenges in practice.
“One of the things we've seen is a considerable variation in knowledge. This is a rapidly changing field and clinicians readily acknowledge that it's hard to keep up. We see variations in guidelines in current care. We see variations in the performance of testing, the adequacy of tissue collection, and variations in multidisciplinary coordination and almost a complete lack of feedback in performance. We see differences between the performance and readiness to perform biomarker testing between academic settings, and as Andrea mentioned, most importantly, community-based settings,” explained Robert A. Smith, senior vice president and cancer screening principal investigator of the National Lung Cancer Roundtable at the American Cancer Society.
While the changing landscape of lung cancer can contribute to challenges in coordination of care, the knowledge of biomarker testing puts the power back in the patients’ hands. Therefore, the Association for Molecular Pathology is working on various educational initiatives – including patient-friendly reports for NSCLC biomarker testing.
“We've been working with LUNGevity in terms of coming together on common terminologies that can be used in biomarker testing and reporting, to really bring some consistency there,” said Dr. Eric Konnick, from the University of Washington and the Association of Molecular Pathology.
“We've also had some surveys of our membership and the wider laboratory community, looking at the effects of COVID, for example, on our ability to do testing and what the work that goes into that testing is, to really give us a better idea of where the weak points are, where we can advocate for changes in policy to help improve the quality of care and consistency of care.”
While challenges and barriers currently exist, one thing is clear: The cancer community is coming together as a whole to educate patients about biomarker testing to ensure they are receiving the right treatment in their cancer care.
To watch the full webinar, visit curetoday.com/webinars-on-demand.
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