Realizing The Potential Of Precision Medicine

Tumor Types & Biomarkers
Tumor Types & Biomarkers

Explore clinical guidelines on why, whom and how to test actionable biomarkers in lung, breast, ovarian and prostate cancers.
- Lung Tumor
  
  EGFR
  
  ERBB2 (HER2)
- Breast Tumor
  
  BRCA1/2
  
  ESR1
  
  HER2
  
  PIK3CA/AKT1/PTEN
- Ovarian Tumor
  
  HRD
- Prostate Tumor
  
  HRRm
  
  PTEN
Testing Solutions
Explore Precision Medicine

Explore Precision Medicine

Implement best practices in your workflow and discover how recent advances are optimizing precision medicine.

Realizing the Potential of Precision Medicine

Collaborate across the MDT to address health inequities and optimize testing pathways.
Realizing the Potential of Precision Medicine

Latest Developments in Precision Medicine

Explore recent advances in diagnostic technologies and novel biomarkers to support precision medicine in your practice.
Latest Developments in Precision Medicine
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Resources

Access a range of resources you can apply in your practice.

FAQs

Find answers to frequently asked questions about precision medicine.
FAQs

Find a Testing Lab

Search our directory of major laboratories that perform diagnostic biomarker testing.
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Glossary

Find definitions for the most commonly used terms in precision medicine.
Glossary

Resource Library

Explore our library of videos and downloadable tools to help optimize your practice and inform your patients.
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Realizing the Potential of Precision Medicine

Realizing the Potential of Precision Medicine

Jump to:

Transforming Care
Removing Barriers
Enhance Your Approach
Considerations for Your Practice
Helpful Resources

Precision Medicine is Changing the Way Cancer is Diagnosed and Treated^1‑3

Precision Medicine is advancing cancer diagnostics and optimizing treatment through a tailored approach to each patient’s genetic and molecular cancer profile.^1–3

In a study of more than 9,000 tumors from 33 cancer types,

57%

Since actionable biomarkers have been discovered in many common tumors, biomarker testing is vital for early cancer detection and determining eligibility for targeted treatment.¹

What the Guidelines Say

American Society of Clinical Oncology (ASCO), College of American Pathologists (CAP), and NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^® ) all recommend the use of tumor biomarker testing to establish eligibility for targeted treatment and clinical trials.^5–12

ASCO, American Society of Clinical Oncology; CAP, College of American Pathologists; NCCN, National Comprehensive Cancer Network.

Meta-analyses and retrospective studies discovered improved response rates, progression-free and overall survival for patients treated with precision therapies than those who are not.^13–18

RISK OF PROGRESSION

Standard
therapies

Targeted
therapy

Targeted therapy contributed to

53%

^aAfter adjusting for other factors in a pan-tumor study of actionable mutations.¹⁷

Cancer targeted therapies have notably improved outcomes. Equitable access to and use of biomarker testing is crucial to ensure that patients don’t miss out on the potential benefits of precision medicine and targeted therapies.¹⁷

Social determinants of health may impact access to biomarker testing and leave the promise of precision medicine unrealized for many.^19–21

Despite a history of targeted treatment availability in non-small cell lung cancer (NSCLC),¹⁹

64%

While biomarker testing was not completed for patients (%) with²²:

Metastatic HER2-positive breast cancer

39%
Advanced ovarian cancer

15%
Metastatic prostate cancer

40%

HER2, human epidermal growth factor 2; NSCLC, non-small cell lung cancer.

Infographic about communication between healthcare providers and their patients about biomarker testing

75%

of patients remembered having a biomarker testing conversation with their multidisciplinary team (MDT)

48%

of patients still struggled with biomarker testing terms²³

By putting communication strategies and formal support systems in place, and improving shared decision-making on treatment options, MDTs can help reduce disparities in cancer-related outcomes while helping patients and caregivers better understand the concept and implications of biomarker testing.²³

Disparities in oncology trials limit precision medicine access, affecting specific subgroups more^20,21

Limited knowledge of underlying cancer biology in racial and ethnic minority groups highlights the urgent need for MDTs to advocate for and prioritize enrollment of these groups (proportionate to their cancer incidence) in future clinical studies. The resulting discoveries can then be used to personalize treatments for underrepresented racial and ethnic groups in cancer with greater confidence.^20,24

MDT, multidisciplinary team.

A systematic review and meta-analysis found that persons with low socioeconomic status were²¹:

17%

less likely to be treated with precision therapies

Further, the intersection of social determinants of health with environmental, and genomic and/or biologic factors and how they influence disease outcomes is not well understood, and highlights the need to capture more data in future precision medicine studies to evaluate the level of impact on health outcomes.²⁰

Standardized testing and reporting protocols to identify and treat all patients eligible for targeted therapies

Improved education on biomarker testing, genetic studies, and genetic counseling in patients living with cancer

Strengthening formal support systems, verbal communication strategies, and MDT coordination to address health literacy barriers on biomarker testing for patients with cancer

Continued implementation of strategies to target economic barriers to testing and treatment

Increased advocacy for diversifying patient recruitment to clinical studies

MDT, multidisciplinary team.

Implement reflexive testing

Shorten the time to obtain molecular test results, minimize tissue insufficiencies, and increase your lab’s testing capacity.²⁵ Reflexive testing may decrease average biomarker testing turnaround time by over 2 weeks.^25–29

Pathologists generally drive reflexive testing protocols, for example, by sharing test results directly with genetic counselors to minimize the potential of missed patients.²⁷

Connect patients with a genetic counselor:

They are uniquely equipped to help MDTs identify people who may have a hereditary cause for their cancer. Promote greater access to genetic counseling services by³⁰:

Educating non-genetic healthcare providers
Triaging patients according to expected complexity
Offering telehealth services

Use consistent terminology:

Synoptic reporting and standard terminology allow for clearer communication of test results to the broader MDT, avoiding misunderstandings.³¹

Refer to our Glossary of common terms in precision medicine:

View Glossary

Form a molecular tumor board:

This multidisciplinary panel convenes regularly to discuss important results during care. This can aid the interpretation of complex genomic data and improve a patient’s access to targeted therapies.^32,33 One study found over half of board-reviewed biomarker testing results led to a change in a patient’s treatment plan.³⁴

Find practical tips on forming a molecular tumor board along with discussions about common challenges and potential solutions.

Assign a patient navigator

Designate a team member to coordinate care:

Patient navigators play a crucial role in providing patients with education, support, and bridging communication with the broader care team.³⁵

Access ASCO’s Cancer.net podcast, explaining the benefits of patient navigators and how to implement a navigation process:

Assign a patient navigator

ASCO, American Society for Clinical Oncology; MDT, multidisciplinary team.

CAP Cancer Protocols provide biomarker reporting guidelines outlining essential reporting elements  based on the latest standards.³⁶

Read CAP guidelines

CAP, College of American Pathologists.

The full potential of precision medicine to transform the lives of patients with cancer relies on addressing health inequities and offering optimized testing workflows that consider^1,19:

Pathologist-driven (reflexive) biomarker testing
Increasing access to genetic counselors, e.g. with telehealth
Ongoing patient education to increase awareness in all communities and build trust
Ongoing MDT education to address knowledge gaps and inform decision-making
Focused strategies to increase clinical study enrollment and representation of patients from various racial and ethnic groups to ensure that diverse communities can benefit from precision medicine
Standardizing terminology and reporting
Keeping regular molecular tumor boards
Appointing patient navigators to support patients throughout their biomarker testing journey and help remove barriers to treatment

MDT, multidisciplinary team.

Helpful Resources

Check out these featured resources to drive understanding and uptake of biomarker testing.

dummy

View more resources

Jardim DL, et al. J Natl Cancer Inst. 2015;107(11):djv253.
Kato S, et al. Nat Commun. 2020;11(1):4965.
Tsimberidou AM, et al. JCO Precis Oncol. 2017;2017:PO.17.00002.
Bailey MH, et al. Cell. 2018;174(4):1034–1035.
Chakravarty D, et al. J Clin Oncol. 2022;40(11):1231–1258.
Allison KH, et al. J Clin Oncol. 2020;38(12):1346–1366.
Wolff AC, et al. Arch Pathol Lab Med. 2023;147(9):993–1000.
Lindeman NI, et al. Arch Pathol Lab Med. 2018;142(3):321–346.
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Prostate Cancer. V.4.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed November 27, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer. V.3.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed October 01, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Breast Cancer. V.6.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed November 11, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Non-Small Cell Lung Cancer. V.11.2024. © National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed October 15, 2024. To view the most recent and complete version of the guideline, go online to NCCN.org
Yi T, et al. Int J Cancer. 2019;145(5):1209–1220.
John A, et al. Oncologist. 2020;25(11):e1743–e1752.
Singal G, et al. JAMA. 2019;321(14):1391–1399.
Schwaederle M, et al. JAMA Oncol. 2016;2(11):1452–1459.
Haslem DS, et al. J Oncol Pract. 2017;13(2):e108–e119.
Tsimberidou AM, et al. J Hematol Oncol. 2019;12(1):145.
Sadik H, et al. JCO Precis Oncol. 2022;6:e2200246.
Aldrighetti CM, et al. JAMA Netw Open. 2021;4(11):e2133205.
Norris RP, et al. BMC Med. 2020;18(1):282.
Goldfarb SD, et al. J Clin Oncol. 2021;39(28_suppl):16.
Fortune EE, et al. Patient Educ Couns. 2023;112:107720.
Lillard JW, et al. Cancer. 2022;128(21):3783–3795.
Hooper K, et al. J Clin Oncol. 2022;[abstract taken from 40(16):3127].
Braxton DR, et al. J Clin Oncol. 2021;[abstract taken from 39(15):e13507].
Anand K, et al. Clin Lung Cancer. 2020;21(5):437–442.
Tsang M, et al. Arch Pathol Lab Med. 2022;146(12):1535–1539.
Seidman AD, et al. Popul Health Manag. 2017;20(4):252–254.
Cohen SA, et al. Am Soc Clin Oncol Educ Book. 2019;39:e34–e44.
Strickland-Marmol LB, et al. Arch Pathol Lab Med. 2016;140(6):578–587.
Salgia R, et al. JCO Oncol Pract. 2021;17(8):e1120–e1130.
Sadaps M, et al. JCO. 2021;39(15):suppl.3128.
Behel V, et al. JCO Glob Oncol. 2022;8:e2200030.
Gorin SS, et al. Ann Behav Med. 2017;51(4):532–546.
Cancer Protocol Templates. College of American Pathologists. Accessed October 01, 2024. https://www.cap.org/protocols-and-guidelines/cancer-reporting-tools/cancer-protocol-templates

NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

Tumor Types & Biomarkers

Explore Precision Medicine

Realizing the Potential of Precision Medicine

Latest Developments in Precision Medicine

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FAQs

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Realizing the Potential of Precision Medicine

Precision Medicine is Changing the Way Cancer is Diagnosed and Treated1‑3

Targeted therapies are improving outcomes across cancer types13–18

Removing Barriers so More Patients Can Benefit From Precision Medicine

While biomarker testing was not completed for patients (%) with22:

MDTs Can Boost Patient Health Literacy for Improved Understanding of Biomarker Testing

Disparities in oncology trials limit precision medicine access, affecting specific subgroups more20,21

Socioeconomic disparities can affect biomarker testing and precision medicine outcomes21

MDT collaboration can help improve equitable access to precision medicine20

Enhance your MDT’s approach to biomarker testing to help improve patient outcomes20

Implement reflexive testing

Connect patients with a genetic counselor:

Use consistent terminology:

Form a molecular tumor board:

Designate a team member to coordinate care:

Considerations for Your Practice

Helpful Resources

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Precision Medicine is Changing the Way Cancer is Diagnosed and Treated^1‑3

Targeted therapies are improving outcomes across cancer types^13–18

While biomarker testing was not completed for patients (%) with²²:

Disparities in oncology trials limit precision medicine access, affecting specific subgroups more^20,21

Socioeconomic disparities can affect biomarker testing and precision medicine outcomes²¹

MDT collaboration can help improve equitable access to precision medicine²⁰

Enhance your MDT’s approach to biomarker testing to help improve patient outcomes²⁰