Biomarkers: small clues with a big impact
- Every patient is unique, and every case of lung cancer is unique
- Your doctor can learn more about your cancer by identifying clues inside your cancer cells, called biomarkers
- A biomarker can be a protein, gene or other substance in the blood or tumour tissue that can help guide treatment decisions
What can my biomarker tell me about my cancer?
Some therapies target certain biomarkers. Testing for your cancer’s biomarker profile at diagnosis helps your healthcare team decide which treatment plan may work best for your unique lung cancer.
There are many different ways your doctor can test for biomarkers. What matters most is making sure a full panel of important biomarkers is checked–like HER2, EGFR, ALK and PD-L1–so your care team has the information needed to determine which targeted therapy may work best for you.
Identifying your biomarker profile
To learn about your biomarker profile, a sample of your tumour is collected and examined under a microscope. Your sample can be retrieved using a tissue or liquid biopsy.
You may feel nervous about your biopsy, but it is one of the most important steps in finding the best treatment option for you. Your healthcare team is there to answer any questions you may have about the procedure and to ensure you are safe and comfortable every step of the way.
Bronchoscopy: a thin, flexible tube is inserted through the mouth or nose into the lungs to collect a sample
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): a thin, flexible tube is inserted through the mouth into the airways where a needle will collect a sample from the lymph nodes
- Transthoracic needle biopsy: a thin needle is inserted through the chest wall into the lung to collect a sample
What your biomarker means for your diagnosis
Your biomarker testing may include all or some of the following biomarkers:
HER2 (ERBB2) | MET | BRAF | KRAS | ROS1 |
EGFR | NTRK | ALK | RET | PD-L1 |
These biomarkers are often found in healthy cells and act as a light switch to help regulate cell growth and division. Normally, cells cycle between “on” and “off”, growing when needed and resting when not. In cancer, changes to the tumour’s DNA can cause these biomarkers to get stuck in the “on” position, breaking the cycle and making your cells grow too quickly.
Your biopsy results can show which biomarker is driving cell growth in your tumour. From here, your doctor can identify available treatment options that target your biomarker.
Videos
Patient video
Biomarkers & me: a patient’s journey to personalized cancer care
Listen to Bev–a Canadian patient diagnosed with lung cancer–share her experience with biomarker testing and the role it played in shaping her cancer care plan.
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Hi, my name is Bev, and I live in Toronto, Ontario.
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Several years ago,
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I had two lingering colds six months apart.
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The second cold, I was coughing so much,
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I thought I had strep throat.
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I booked an appointment with my family doctor.
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And she fortunately
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ordered a chest x-ray as part of her examination.
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That decision of hers likely saved my life.
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At the end of various tests,
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my husband and I met with the doctor,
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and he gave us the diagnosis of stage 4 lung cancer.
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We knew something was very serious,
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but we were definitely not expecting stage 4 lung cancer
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or to be told that this would kill me.
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It was a shock because I’ve always been healthy
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and I’m a never smoker.
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Once we had the diagnosis,
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the doctor ordered a biomarker test,
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a tissue biopsy, to clarify
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what was the particular mutation that I had.
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It’s really important to know early in the cancer journey
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what the particular biomarker is.
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It is part of the trend towards precision medicine
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and provides the opportunity to give the best
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and most appropriate treatment
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for the particular biomarker.
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We got the results of the biomarker testing,
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and the doctors were really pleased to tell us
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that I had an actionable mutation.
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At the time, I didn’t understand
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what they were talking about.
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But I realized that they were able to select a
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targeted therapy for me that was specific
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to my particular mutation.
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When other people are in a similar situation,
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I think it’s really important that they
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appreciate the value of having a
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biopsy to determine their biomarker.
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When I learned more about
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targeted therapy and precision medicine,
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I realized that I was very fortunate
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to have had the test,
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let alone to have a targeted therapy
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specific to my type of cancer.
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The biomarker testing
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was the best thing that was done for me.
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It’s given me a high quality of life
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for a lot longer than they predicted.
Healthcare professional video
The power of biomarkers: advancing personalized cancer care
Medical oncologist Dr. Vishal Navani shares his experience with biomarker testing and the difference it has made for his patients diagnosed with lung cancer.
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I’m a medical oncologist.
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I care for patients with lung cancer,
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and I’ve been practicing for 14 years.
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Cells are the building blocks of the body.
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Every organ has billions and billions of cells.
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Cancer is a disease where those cells
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grow and divide in a disordered fashion.
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Biomarkers are the errors in a cell’s instructions,
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the problems in its code, its DNA,
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that make the cell grow in a
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disordered, aggressive fashion.
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So, understanding those biomarkers tells us
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the cell’s faulty instructions
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and allow us to better treat the disease.
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It’s critical to complete biomarker testing
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as early as possible in the diagnostic pathway.
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Biomarkers are critical to understand
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the nature, prognosis
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and treatment options for some patients with this disease.
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Biomarker testing is usually done on
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tissue collected from a patient with lung cancer.
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If we find an actionable biomarker in a patient’s cancer,
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it allows us to precisely
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tailor a treatment
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based on that unique cancer
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and that unique individual
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rather than using other less precise options.
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Without understanding the biomarker profile
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and confirming the diagnosis
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for a patient with lung cancer,
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we’re in the dark
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about prognosis and treatment options.
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Cancer care is moving
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every day towards more precise treatment.
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If you think about this disease like
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a garden that has weeds growing,
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but those weeds are in between normal flowers,
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you just want to kill the weeds
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and not affect your normal cells,
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your normal tissue, the flowers.
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Biomarkers allow precise therapies
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that are akin to weed whackers,
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getting rid of the weeds,
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but sparing the normal flowers.
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It’s critical that a patient ask whether
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that biopsy that proves
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that they have lung cancer
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has been tested for biomarkers
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to help inform prognosis
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and treatment option discussion.
The next best step
Understanding your diagnosis and biomarker profile is an important step in your journey. To learn more about lung cancer and biomarkers at your own pace, download the biomarker patient booklet. To help you prepare for your appointment with your healthcare professional, download the patient discussion guide – designed to help you ask the right questions about your biomarker testing.
Patient discussion guide
Biomarker patient booklet
HER2=human epidermal growth factor receptor 2; EGFR=epidermal growth factor receptor; ALK=anaplastic lymphoma kinase; PD-L1=programmed death-ligand 1; ERBB2=erb-B2 receptor tyrosine kinase 2; MET=mesenchymal epithelial transition factor receptor; BRAF=v-raf murine sarcoma viral oncogene homolog B; KRAS=Kirsten rat sarcoma viral oncogene homolog; ROS1=c-ros proto-oncogene 1; NTRK=neurotrophic tyrosine receptor kinase; RET=rearranged during transfection.
