You need a complete answer to provide the best treatment.
Non-small cell lung cancer (NSCLC) is not a single disease, but a collection of cancer types whose pathology is classified by histology (cells) and molecular profiling (genetic and protein biomarkers).
The discovery of molecular alterations, such as EGFR, ALK, and ROS1, have improved physicians’ ability to manage advanced lung cancer. Each alteration signifies a distinct molecular sub-classification of this disease. Studies continue to evaluate other targets, including T790M, for treatment efficacy monitoring and for identifying new targeted therapies.
Identifying these markers is crucial to offering patients the most advanced treatments available.
The NCCN, ASCO, and The College of American Pathology (CAP) all provide guidelines regarding which patients should receive molecular profiling, when they should be profiled and what tests should be ordered.
Issues with Obtaining Tissue
A significant number of patients with lung cancer do not have enough tissue available from a surgical biopsy for molecular testing. This can be a result of:
- Nodule size and location
- Biopsy technique – fine needle aspirate (FNA)
- Biopsy frequency risk
Risk of Biopsies in Lung Cancer
Biopsy-related adverse events can delay treatment, add to the cost of treatment, and even lead to hospitalization.
Numerous studies and publications have examined the challenges of obtaining lung biopsy tissue. A recent study, presented at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology, indicated that of the 1,744 patients who received a lung biopsy, 19.3% (n = 336) experienced a biopsy-related adverse event.1
Adverse events can include:
- Respiratory failure requiring mechanical ventilation
These adverse events delay treatment and lead to hospitalization. Beyond the medical implications, there are significant cost considerations. According to this study, the average cost of a biopsy with an adverse event was approximately four times higher than a complication-free biopsy ($37,745 compared to $8,869).
Monitoring Treatment Resistance
Patients receiving targeted therapies for lung cancer may develop some type of resistance to the targeted therapy. Understanding this resistance can lead to a more appropriate treatment plan or identify patients for clinical trials.
However, serial surgical biopsies are simply not practical for monitoring treatment resistance.
Biocept and Liquid Biopsies—Completing the Answer™
Whether you are unable to get sufficient tissue from a traditional biopsy, or you need to monitor treatment resistance without serial biopsies, a liquid biopsy from Biocept can help complete the answer.
Biocept has developed the most advanced methods for finding cancer cells and DNA fragments in the blood. Our CLIA-certified and CAP-accredited laboratory provides tests that establish up-to-date clinically actionable biomarker status. Liquid biopsies can provide the same type of information obtained from a tissue biopsy—but from a non-invasive simple blood test. And, because Biocept uses blood, real-time information about a patient’s cancer and how they are responding to treatment, can be determined.
How Does it Work?
A liquid biopsy from Biocept is a fast, easy way to establish biomarker status.
Step 1: Order a Biocept blood test. Your patient can get their blood drawn the same day, at any lab. Please contact customer service for Biocept Collection Kit supplies.
Step 2: The sample is sent via Fed-Ex to the Biocept lab. Our CLIA-certified, CAP-accredited lab isolates cancer cells and DNA fragments and uses analytically and clinically validated reagents to look for standard, clinically relevant biomarkers.
Step 3: Biocept will provide your physician the results within 3-5 days for CTC detection, and may require 2-5 days more for additional biomarker testing when the sample is received into our laboratory. In most instances this is faster than results performed on tissue, with the benefit of not having a surgical procedure.
Who pays for a liquid biopsy? Biocept accepts all insurance and will bill on behalf of the patient. In addition, Biocept has a Financial Assistance Program (see Billing Policy), with payment plans available based on the patient’s financial situation. We are committed to excellence and are here to assist with any questions or concerns you may have. Please call 888.332.7729 M-F from 8-5 Pacific Time to discuss individual claims and policies.
- Lokhandwala T, Dann R, Johnson M, et al. (2014, October). Costs of the Diagnostic Workup for Lung Cancer—A Medicare Claims Analysis. Presented at the Chicago Multidisciplinary Symposium in Thoracic Oncology, Chicago, IL.
- ALK, anaplastic lymphoma kinase; EGFR, epidermal growth factor receptor; HER-2, human epidermal growth factor receptor 2; KRAS, V-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog; MEK1, mitogen-activated protein kinase enzyme 1; NRAS, N-rat sarcoma oncogene; PiK3CA, phosphatidylinositol 3-kinase catalytic subunit alpha.
- Amp, amplification; EGFR, epidermal growth factor receptor; HER-2, human epidermal growth factor receptor 2; MET, metastasis; PiK3CA, phosphatidylinositol 3-kinase catalytic subunit alpha; SCLC, small-cell lung cancer; TKIs, tyrosine kinase inhibitors.