Dr Andrey Antov recognizes how important the role of the navigator is in dealing with genetic and genomic testing, as the navigator often needs to help the patient gain access to the appropriate therapy, work with different stakeholders, monitor data, and more.
Dr Andrey Antov provides an overview of the role of Jackson Laboratory in the field of cancer genetic testing and in the education of nurses and navigators who co-manage patients at high risk or with a diagnosis of cancer.
Dr Sanjiv Agarwala predicts that the cancer biomarkers of the future may be “mobile biomarkers,” meaning measures of the tumor microenvironment or immune response that change with therapy and may be able to determine treatment efficacy.
Dr Sanjiv Agarwala discusses the usefulness of MSI and TMB as novel biomarkers for various cancer types. His argument is that the first FDA approval of a therapy based on MSI rather than tumor type makes this biomarker useful, but TMB is not yet ready for “prime time.”
Dr Sanjiv Agarwala describes best practices developed at St. Luke’s Cancer Center, where a committee has been formed in which clinicians and pathologists meet to reach consensus on reflex testing of molecular biomarkers, as well as the value of biomarker testing in enhancing patient care.
Dr Sanjiv Agarwala argues that much of the biomarker data in melanoma presented at ASCO 2018 are around the value of PD-L1 testing; however, even PD-L1–negative melanoma patients seem to respond to anti–PD-1 therapy, although some studies suggest PD-L1–negative patients may be better candidates for combination immunotherapy.
Dr Sanjiv Agarwala reviews real-world data presented at ASCO 2018 on immunotherapy of melanoma that serve to reassure providers regarding current treatment approaches, but do not offer any significant practice-changing results.
Dr David Spigel discusses challenges and solutions to incorporating cancer biomarkers into patient care, including finding pathology resources to do the testing, issues around reimbursement, and educating colleagues on the value and operational aspects of biomarker testing in delivering personalized therapy to patients with cancer.