Defining Your Treatment

Genomic Testing (GCP)

Tumor tissue is a critical factor required to determine the genetic profile of your cancer. Unlocking your lung cancer's genetic profile is critical to pursuing the most effective treatment for your disease. The earlier you identify your cancer's genetic signature the easier it is to identify promising , possibly the most effective cancer treatment for your disease.

Using the diagnostic “tree” analogy, this more detailed genomic analysis can identify the “twig” and / or “leaf” of your disease description.

There are several approaches to identify this cancer signature and some methods are faster and more comprehensive in analysis than others.

Genetic sequencing analyses, aka GCP, are increasingly performed at specialty comprehensive testing companies. The benefit of using such companies is that they will test your biopsy against an extensive panel of cancer markers, all at the same time saving your Team precious decision time and generating a complete, consistent analysis of your tumor biopsy tissue. These genomic test panels are growing more comprehensive over time as the extent of the identified cancer markers have exploded in the last ten years.

In contrast, more traditional genetic analyses methods test for the most common genetic mutations one at a time, in a sequential manner sending out, receiving back your biopsy each time and then sending it out again to a different lab for an additional specific marker test. This older process takes much precious time, effort and the lab analyses are not consistent as they are conducted at different sites by different people.

As an example, my Thoracic Oncologist sent my tumor biopsy for comprehensive genetic profiling (GCP) to Foundation Medicine® to have the FoundationOne®CDx panel conducted on my tumor sample. My second round of GCP testing in 2014 identified that I had the rare ROS1 mutation and immediately started treatment on an oral drug that directly targets that cancer mutation. This GCP diagnostic test analyzed over 300 genes as compared to only 7 identified cancer markers in 2009 when I had my initial GCP test conducted.

In the last several years, genomic testing facilities now include PDL1 immunotherapy sensitivity testing of the tumor tissue as a part of their panel. This test result may identify an alternate way to fight your cancer based upon the profile your tumor presents; a treatment approach called Immunotherapy.

Here's a link to Foundation Medicine®'s, FoundationOneCDx website for more information:
https://www.foundationmedicine.com/test/foundationone-cdx

The comprehensive genomic testing example above details only one of several genomic testing (GCP) companies and tests offered. You should rely on your Specialty Oncologist( for lung cancer that's a Thoracic Oncologist), to define which comprehensive genomic testing company and test is best for your circumstance.

FISH Diagnostic

Think of Comprehensive Genomic Testing (ie CDx) as a broad analysis looking at many genomic mutations or targets to hopefully identify a specific mutation in a tumor sample run all at one time.

There is another diagnostic technique referred to as “ FISH,” a deeper level analysis of a tissue sample to quantify, for instance, a percentage of a certain mutation present in that sample. FISH is deeper but much more narrow analysis of tumor tissue for an identified genomic testing spectrum. For instance, my Oncologist used this test to validate the findings identified by a higher level comprehensive genomic analysis conducted in 2014 was indeed a valid and robust genomic indicator. He felt FISH added an additional layer of validity and also used it for my initial comprehensive genomic testing conducted in 2009.

The more information you learn about the genomic details of your cancer and you're teamed with a knowledgeable cancer Specialist to guide your decisions, the higher the likelihood you can survive this complicated type of cancer. The earlier you find out about your cancer's unique signature, the less likely it will spread to other areas because your Oncologist will have narrowed your treatment options to those with the highest probability of success.

Questions to ask your Oncologist

1. Please explain the results of the genomic testing profile.

2. Does my cancer have any unusual or especially challenging aspects to it?

3. Do the results of my genomic testing profile affect your treatment approach to my disease; what are my current or future treatment options?

4. What treatment regimen do you currently suggest?

5. When would I start treatment and for how long?

6. Will there be another treatment regimen following shortly after this regimen?

7. Does your medical institution offer clinical trials for my cancer type / mutation? Are there any promising clinical trials for which I might be a candidate?

8. What other medical institutions offer clinical trials that look promising for my cancer type?