Recently I had a friend reach out asking about biomarker testing. Her father was diagnosed with lung cancer, and his doctor said they would be doing molecular profiling as part of his treatment planning. She wanted to better understand what that meant as part of her father’s care.
I broke it down in an analogy. Consider social media dating sites, where we create profiles hoping people will notice us by showing how different and unique we are from the next person, but also showing important similarities—creating a sense of connection with uniqueness and building relationships. So why would you make a profile of your cancer? Well, just like you are different from anyone else on this planet, so is your cancer, but there are some characteristics that it may display that can direct you to the right treatment. Testing enables you to select treatments that are most likely to help you, while at the same time sparing you from getting treatments that are not likely to help.
What Is Molecular Profiling?
Molecular profiling includes tests that detect the presence of biomarkers. Biomarkers are genes, proteins, or other molecules that are a sign of a normal or abnormal process, or of a condition or disease. This testing can be done on tissue from a biopsy or on a blood draw sample.1 You may be familiar with genetic testing, which looks at specific inherited changes (sometimes called mutations) in a person’s genes that may increase the risk of diseases; molecular profiling looks at the genetics of your tumor.
Per the National Institutes of Health, molecular profiling may be called by different names.2
- Tumor testing
- Tumor genetic testing
- Genomic testing or genomic profiling
- Molecular testing or molecular profiling
- Somatic testing
- Tumor subtyping
Molecular profiling has become commonplace and is considered standard of care when planning your personalized treatment plan.
Why Is Any of This Important to You and Your Doctor?
For a long time, many chemotherapy drugs would attack not only the cancer but would also attack normal cells not affected by cancer, creating numerous side effects. Scientists have discovered that certain biomarkers are found only in certain cancers, and drugs have been developed that target those specific markers—this is called precision medicine or targeted therapy.
Molecular Profiling and Clinical Trials
While there are now many targeted drugs available for the treatment of cancer, researchers are continually looking to match new drugs to biomarkers through clinical trials. This may start with a type of clinical trial called biobanking. In this type of trial, patients consent to send a tissue sample of their tumor and/or blood for scientists to analyze to find new biomarkers to target. There are also trials that test new medications against known biomarkers.
Trials that look for new indications are another type of trial. In these trials, treatments that have worked well for one type of cancer are tested for use as treatment for a different type of cancer. Consider, for example, the HER2+ cancers. The drug Herceptin (trastuzumab) was first used to treat breast cancer but, after many trials, is now used to treat cancers of the digestive tract. There are trials that include biomarker testing as part of the trial and then offer different treatments according to which biomarkers are found.
Patients should feel comfortable asking their provider about molecular profiling as well as clinical trials as part of a personal treatment plan. Feeling empowered to work with the care team for the best treatment options should be a priority.
References
- Malone ER, Oliva M, Sabatini PJB, et al. Molecular profiling for precision cancer therapies. Genome Med. 2020;12:8.
- National Cancer Institute. Biomarker testing for cancer treatment. Accessed September 6, 2024. www.cancer.gov/about-cancer/treatment/types/biomarker-testing-cancer-treatment
