Fast Five Quiz: Precision Medicine in Cancer

Winston W. Tan, MD; Evelyn S. Marienberg, MD


January 06, 2023

With the increasing number of approved targeted therapies, many patients with metastatic disease are good candidates for genomic testing. Patients with fewer or no standard treatment options are also candidates for early molecular profiling and may benefit from enrolling in a clinical trial evaluating a particular alteration (ie, basket studies that are agnostic to tissue and explore specific genomic variants).

Genomic biomarker testing is often recommended for patients with advanced cancer. To be considered a candidate for a targeted therapy, however, a patient must meet specific criteria which are dependent upon the therapy's approval. These vary by disease.

Mutations that impair gene function are sometimes inherited (ie, BRCA1 and BRCA2 ); however, most mutations are de novo. The National Cancer Institute reports that these inherited genetic mutations play a major role in up to 10% of all cancers.

Most patients with early-stage disease undergoing traditional treatment generally do not require somatic gene panels because next-generation sequencing results do not show alterations beyond what can be garnered from standard evaluation. With the rapid evolution of targeted therapy, however, the utilization of genomic testing is expected to expand.

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