Driven by innovations in precision medicine, advances in cancer treatment over the past decade have been significant. As costs continue to drop for molecular analysis, comprehensive biomarker testing will play an increasingly important role in the understanding of cancer and its treatment.
As things stand now, however, while a limited number of standard biomarker tests may be ordered, comprehensive biomarker testing is not done routinely. That’s according to Nicholas Robert, MD, medical director at Ontada, an oncology technology and insights business that is part of McKesson.
“From the data we see, while the utilization of molecular tumor profiling to inform treatment continues to improve, there are barriers to adoption” Robert says. One of the challenges is lack of awareness, he says, but the bigger obstacle is that it’s cumbersome because of issues such as long turn-around time in providing data back to the oncologist and the number of steps required in the process, from procuring the tissue to identifying an appropriate laboratory for analysis.
Fortunately, there are solutions for overcoming these challenges.
Comprehensive biomarker testing points to the best treatment
Frequently, biomarker testing is done from tissue taken during surgery or biopsy. The amount of tissue taken may only be used for a limited number of standard biomarker tests instead of broader testing, with a potential consequence of a reduction in the number of treatment options.
When faced with not having enough tissue to use for comprehensive biomarker testing, providers can order liquid biopsies. They can, for example, draw blood, in which DNA from the tumor can be found circulating. It’s easy, can be done right in the office, and the results come back faster than with tissue—usually days instead of weeks, Robert says.
“The good news is there has been an increase in awareness about the utility of having biomarkers and the importance of having these results prior to starting the appropriate therapy,” he adds.
But if providers aren’t ordering comprehensive biomarker testing, they won’t have the granular molecular insights that can point them to the best treatments that are available. “If you’re missing information, you’re going to give general treatment,” he says, noting that “patients generally do better with targeted therapy versus chemotherapy.”
“For life sciences, biomarker testing is critical because it not only increases the likelihood that patients receive the most appropriate treatment, but it also gives us the insights to develop targeted therapies of the future,” says Michelle Myers, vice president of life sciences partnerships at Ontada.
“Many of the oncology drugs approved today are tied to one of these genetic markers,” she says. “I think as we evolve through time, we'll probably see more and more drugs being approved that are tumor agnostic and more targeted to specific genetic mutations.”
Technology leads to actionable information
With new drugs and new research coming out at a rapid pace, it is essential for providers to be able to rely on technology that puts the information they need at their fingertips in real time, says Anita Vila-Parrish, PhD, director of product management at Ontada. For example, comprehensive biomarker guides are integrated into iKnowMedSM, Ontada’s electronic health record (EHR). These guides are updated with actionable information on new molecular testing.
These types of decision tools reduce the burden on providers by helping them determine which tests they should order for specific diseases and the possible treatment options. “As more and more targeted therapies have come to market—which means they are driven by a biomarker result—having that information accessible and at your fingertips when you're making a decision to put a patient on a therapy is critical,” Vila-Parrish says.
And if the EHR, like iKnowMed, has ordering support, providers can not only figure out which tests to order, but also order them directly through the EHR. Bringing that automation into the workflow, Vila-Parrish notes, further reduces the barriers to comprehensive biomarker testing.
With integrated EHR systems such as iKnowMed, the power of precision medicine is also amplified, because it offers insights for individual patients and informs real-world evidence and research, she adds.
When the results of comprehensive biomarker testing become part of patient charts in the EHR, the analysis of treatment patterns and effectiveness become enriched with this depth of data. With population study capabilities embedded in the EHR, providers can review their patient population to see which particular biomarker mutations they have within their practice’s population and consider how that information may be used in clinical trials.
And as comprehensive biomarker testing informs more research, the awareness of its potential becomes more widely known and understood. Ultimately, that means more treatment options for extending and saving lives.