Biomarkers | NSCLC

Top 3 Reasons to Know Your Biomarker Status

1. To get a personalized, precision diagnosis
2. To find the most advanced treatment options
3. To better understand and manage your specific cancer type

What is a biomarker?

Biomarkers, short for biological markers, are molecular signs that tell us a specific process, normal or abnormal, has occurred in the body or is ongoing. In lung cancer, which has many types and subtypes, biomarkers provide important details beyond what a biopsy can. Many precision treatments, based on biomarkers, have been Food and Drug Administration-approved, and additional targeted therapies may be available in clinical trials. You can learn what your biomarkers are by taking a biomarker test.

What is biomarker testing? todo

Biomarker testing, also known as genomic screening, can identify which biomarkers characterize your particular tumor. The test can be done using tissue from your biopsy or with a liquid biopsy, which uses a blood sample. Biomarkers are typically identified by three or four letters, such as ALK or EGFR. The results of your biomarker test can help your doctor decide if a targeted treatment is right for you. The great advantage of these precision treatments is that they can destroy cancer cells without harming healthy tissues. Sometimes called "miracle drugs," they may be even effective in late-stage cancers when other treatments have failed.

How do you test for biomarkers?

During a biopsy or surgery, a tumor tissue sample can be taken and sent to a lab for biomarker testing, which can :

search for many biomarkers at once, using only a small sample of tissue
use fluorescent dye to identify cancer genes
use antibodies to locate biomarkers in a tissue sample

Cancer DNA can also be detected by performing a liquid biopsy from a blood sample.

How does biomarker testing determine my treatment plan?

Having your biomarker information gives doctors a full picture, called a genomic profile, of your unique tumor. The results will show if your tumor can be treated with an FDA-approved targeted therapy or if immunotherapy is likely to help you. Test results will also provide information about any markers that are being studied in clinical trials. This helps doctors make better-informed recommendations to customize your treatment plan.

Who is most likely to benefit from biomarker testing?

Patients with adenocarcinoma, a subtype of non-small cell lung cancer, are most likely to show gene changes in ALK, BRAF V600E, EGFR, KRAS, MET, NTRK, RET and ROS1 — biomarkers that have FDA-approved treatments. Doctors may also use biomarker tests for patients with squamous cell or small cell lung cancers who have never smoked. All patients can have their PD-L1 levels checked to explore whether immunotherapy is a good option for them.
Not everyone with lung cancer will have biomarkers that can be treated with targeted therapies. It’s important to work closely with your doctor and discuss all of your treatment options at every step of your journey.

What if I have already had a biopsy and my tumor was not tested? If the tumor sample from your biopsy was not tested for biomarkers, you may want to ask your doctor if biomarker testing is right for you and if there is any leftover tissue that can be tested. Treatment can sometimes cause the makeup of a tumor to change, so if your tumor resists treatment, doctors may recommend an additional tissue biopsy or liquid biopsy to get the most accurate and timely information about your tumor.

Can I get a biomarker testing if my treatment has already started? If your tumor wasn’t tested before you started treatment, it might not be too late. Ask your doctor about testing leftover tissue or doing a liquid biopsy, which only requires a blood sample. testing

Is the cost of biomarker testing covered by insurance? Biomarker testing is not always covered by insurance. Your doctor, nurse navigator, or financial support team may be able to help you understand the specifics of your insurance coverage. Still, it is important to ask about any out-of-pocket costs for biomarker testing.The cost of biomarker testing varies widely depending on the type of test you get, the type of cancer you have, and your insurance plan. Visit the Financial Resources page to learn more.

<< Previous: Survivorship Next: NSCLC Biomarkers >>

There are several biomarkers associated with non-small cell lung cancer (NSCLC), and the U.S. Food and Drug Administration has approved treatment for the biomarkers listed below.

ALK FUSION

The ALK biomarker is found in about 5% of lung cancer patients, often in younger people, women, and nonsmokers.

BRAF V600E

The BRAF biomarker occurs in about 2-4% of NSCLC patients, more commonly in smokers.

EGFR

Approximately 15% of NSCLC patients are EGFR positive, more often found in people of East Asian descent, women, nonsmokers, and light smokers.

KRAS

KRAS mutations are most often found in people who smoke or have smoked in the past and account for about 13% of NSCLC cases.

MET EXON 14 ALTERATION

About 3-4% of people with NSCLC test positive for MET. It is more common in older people and smokers.

NTRK FUSION

Less than 1% of people with NSCLC test positive for this biomarker. The cause is not known.

PD-L1

PD-L1 is a protein that prevents the immune system from killing cancer cells. High percentage presence of this biomarker can be treated with immunotherapy.

RET FUSION

RET is found in about 2% of NSCLC cases. It is more often found in younger people and people who have never smoked.

ROS1FUSION

Approximately 1-2% of people with NSCLC test positive for ROS1. It’s most often found in younger people, women, and nonsmokers.

<< Previous: Biomarkers Next: Biomarker FAQs >>

Show All

If you have NSCLC, it’s important to discuss comprehensive biomarker testing with your doctor. This test looks for malfunctions or mutations in every gene with a known connection to lung cancer.

Your oncologist will send your tissue sample to a laboratory with expertise in biomarker testing. This might be the pathology department of the hospital or clinic where you are being treated or a certified outside laboratory. Results from this testing usually come back in one to two weeks.

Yes, biomarker testing is an important part of precision medicine, also called personalized medicine. Precision medicine is an approach to medical care in which disease prevention, diagnosis, and treatment are tailored to the genes, proteins, and other substances in your body.

For cancer treatment, precision medicine means using biomarker and other tests to select treatments that are most likely to help you, while sparing you from getting treatments that are not likely to help. Learn more about such targeted treatments in the Treatments tab.

Biomarker testing is not always covered by insurance. Your doctor, nurse navigator, or financial support team may be able to help you understand the specifics of your insurance coverage. Still, it is important to ask about any out-of-pocket costs for biomarker testing.

The cost of biomarker testing varies widely depending on the type of test you get, the type of cancer you have, and your insurance plan. Visit the Financial Resources page to learn more.

<< Previous: Non-Small Cell Lung Cancer Biomarkers Next: Treatment Options >>

Please review this information with your doctor and use this to further the discussion about your care and treatment options.

Do You Already Know Your Biomarker?

Take this quick survey to get your own custom treatment guide to see all the current Food and Drug Administration-approved drug options based on your biomarker.