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).
Although genetic biomarker testing is usually recommended for patients with advanced cancer or patients who have already undergone conventional therapies, it is also performed regularly among patients with certain types of cancer, including non–small cell lung cancer (NSCLC), breast cancer, and colorectal cancer. More generally, to be considered as a candidate for a targeted therapy, a patient must meet specified criteria that vary by disease and are established by the US Food and Drug Administration (FDA) upon the therapy's approval.
Mutations that impair gene function are sometimes inherited (ie, BRCA1 and BRCA2); however, most mutations are de novo. The National Cancer Institute reports that inherited genetic mutations play a major role in about 5 to 10 percent of all cancers.
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.
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Cite this: Winston W. Tan. Fast Five Quiz: Precision Medicine in Cancer - Medscape - Jul 15, 2021.