What Else Do I Need to Know About Getting My Tumor Tested?

What Size Tissue Sample Is Needed For Testing?
The more tissue, the better. In addition to the core biopsy mentioned on a previous page, tumor tissue can be obtained through bronchoscopy, lymph node biopsy, mediastinoscopy, CT-guided core needle biopsy, and via the VATS (Video-Assisted Thoracoscopic Surgery) procedure.

Where Do I Go To Have My Tissue Tested?
Many academic cancer centers currently offer comprehensive tumor testing. Outside of these facilities, testing can be done through various “CLIA-certified” companies and laboratories in the US. Your local oncologist should order these tests. Once ordered, the local hospital pathology department is responsible for sending your tumor tissue to the appropriate testing facility. Your local pathologist is an important member of your treatment team. (See list of resources here)

The Lung Cancer Mutation Consortium (LCMC) represents the largest national initiative to prospectively examine non-small cell lung cancer tumors, and match patients to the best possible therapies. Currently, the LCMC includes 16 leading cancer centers across the country.  The primary goal of the LCMC is to provide the most up-to-date care for lung cancer patients, while collecting valuable information about the frequency and characteristics of abnormalities found in lung tumors to further improve patient care for the entire lung cancer community.

How Long Does It Take To Get Results?
Once your tissue is sent for analysis, results will take approximately 1-4 weeks, depending on the amount and quality of the tumor tissue collected in the biopsy. The tests themselves are relatively straightforward. Processing time is determined by the time it takes your local hospital to locate, prepare, and send your tumor specimen to the testing facility. If your treatment is contingent on the test results, your doctor can request the test be expedited.

Are any blood tests available for testing my cancer?
VERISTRAT  is a serum (blood) test that can be performed on all advanced non-small cell lung cancer patients. The test does not require tissue and can quickly predict whether a patient is likely to benefit from taking Tarceva® or standard chemotherapy regimens if the patient does not have the EGFR mutation. It is also useful in situations where it is not possible to obtain actual tumor tissue for analysis.

If There Is Little Sample Available, What Would Be Most Important To Test?
Currently, because of the direct therapeutic implications, EGFR and ALK would be the priority. Discuss this with your healthcare provider. Make sure to ask your doctor about next-generation sequencing.

What does “Treatment Resistance” refer to?
A patient being treated with a targeted therapy drug can develop resistance to that drug after a period of time. This means that the drug stops working because the tumor cells develop new mutations that effectively “outsmart” the drug, allowing the cells to grow. “Second and third generation treatments” are often available in clinical trials that overcome this drug resistance, and tumor cell growth can once again be contained.

What about tumors testing negative for treatable mutations?
If no treatable mutations are identified, a patient may be offered chemotherapy with or without targeted therapies. A patient can take advantage of cancer centers doing expanded testing or enroll in a clinical trial for any new targeted therapy under investigation.