Biomarker Testing Stewardship Community

Welcome to the discussion forum for BTN Module One: Foundations of Precision Medicine and Personalized Cancer Care Delivery!

We know that talking about complex topics like biomarkers and precision medicine can feel intimidating at first, but this community is here to learn and grow together. To break the ice and apply a learning objective from our first BTN module, let's start with a practical, high-impact question.

Your challenge:  If a friend or family member were recently diagnosed with cancer, and they asked you to briefly explain the most important reason they should be asking their oncologist about "biomarker testing," what would you tell them?

Jump in and share your perspective!

Cancer tumor treatment is not a one size fits all.  It's not as easy as the doctor can just give you any medication chemo radiation and it will work.  The oncology team must first find out what type of tumor it is.  Also if there may be another type hiding within.  Biomarkers narrow down and define it.  One example is a breast tumor.  Although it's located in the breast did originate in another area of the body.  

Secondly biomarkers can tell the doctor what treatments will attack this tumor.  The wrong type of treatment doesn't help.  If the treatment given is specific for colon cancer its not going to help with other types of cancers.

Biomarkers are also useful in telling the doctor how well the treatment will work

Absolutely true, thanks for Sharing Doreen-in addition to helping doctors identify the specific type of cancer and choose the most effective treatment, it also helps genetic counselors identify hereditary causes and risks and also provides information on the appropriateness of certain therapies.  It's a key step in personalizing care, choosing effective therapies and avoiding those that won't work for a certain tumor type or condition.

Our bodies have specific capabilities and attributes amongst ourselves. One example is the CYP enzymes in the liver and how different types of CYP can metabolize statins effectively (or ineffectively). Asking your oncology team to determine the blueprint of your genetic structure will set the stage for finding effective treatments and not waste your time and effort in suboptimal treatment plans.

Many patients can get confused when the discussion goes into "molecular" or "genetic" testing. Since these terms may refer to germline and/or somatic testing, it's important to explain why these tests are important, how they may inform treatment decisions, and how germline results may impact family members. 

Well, My this context is for my Patients .....!
    When we say genetic or molecular testing terms, it simply means we are checking your body's instruction book and your DNA in detail. It's just like a small spelling mistake can change the whole story in a book, a tiny change in your DNA can sometimes cause illness. 
Germline testing looks at the DNA you were born with, the one you got from your parents. If we find something here dramatic, it can sometimes help your family members too and next generation to get rid from that sort of problem that you are facing now.
On the other hand, Somatic Testing looks only at the changes that happened inside the cancer cells. These are not inherited they just developed in the cancer with time. oif we will find these changes that only can be possible with genetic and moelcular testing, we will provide you right treatment, like which medicine will work best for your specific cancer type, stage and phase of cell. 
So basically, these tests help us to understand story of your body what you got from your Mom and DAD. After these genetci and moelcuar tetsing, we only be able to treat you as well NEXT generation s that are coming after few decase from you guyz. We can treat you smarter and maybe protect your loved ones too.

   > Trust us,     we will try our best and bestest way to save you from this dig that you have in shae of Cancer. 

The NCCN guidelines usually provide clear indications for testing with demonstrated clinical utility. Ask about the clinical context and the specimen source, including diagnostic tissue from a primary biopsy, cell free DNA from procedural fluids such as pleural effusions, or peripheral blood cell free DNA for measurable disease monitoring. Ask whether sequencing is tumor only or tumor and normal, since a matched normal control can distinguish somatic from germline variants. For liquid biopsy, ask whether the assay is tumor informed or tumor naive, because prior tumor genotyping influences the sensitivity and specificity of assay performance. Finally, be reassured that oncologists routinely consult with pathologists to optimize care management.