An interview with Dr Shapochka on the use of biomarker testing at disease progression
Dr Shapochka is molecular pathologist specialized in cancer genomics in Kiev, Ukraine. Over his career, he has been facing the complex task of providing the treating physicians with the answers they need to make informed treatment decisions for their patients. In this interview, he explained the reasons why he has been using comprehensive biomarker tests and the hope they may bring to cancer patients at disease progression.
OncoDNA: Dr Shapochka, as molecular pathologist, you have been using comprehensive biomarker testing in your laboratory. Could you please explain the value it brings in oncology?
Dr Shapochka: Comprehensive biomarker testing can provide additional treatment options for cancer patients. It enables us to spot some molecular markers, fusions, or mutations for targeted therapy; or predictive biomarkers for immunotherapy such as microsatellite instability or tumor mutational burden.
OncoDNA: Could comprehensive biomarker testing benefit all patients?
Dr Shapochka: In my daily practice, I have seen many patients who have exhausted standard of care and are left without any options. This challenge happens to every second or third cancer patients, I’d say. When patients do not respond to standard therapies, we suggest using molecular profiling with a broad NGS panel. Sometimes, it helps us detect biomarkers for targeted therapies or immunotherapy. We may not find targets in all patients, but it is the best option we have.
OncoDNA: Why use broad NGS panel?
Dr Shapochka: Small NGS panels cover the only option of targeted therapy. Such tests will screen for fusions and mutations. Broad NGS panel on the contrary will look for additional biomarkers, such as MSI, TMB, PD-L1 for immunotherapy. Therefore, there are greater chances to identify additional treatment options with comprehensive biomarker tests.
OncoDNA: When do you recommend using comprehensive biomarker testing?
Dr Shapochka: I think that molecular profiling with broad NGS panels should be used more frequently. It allows us to screen for treatment options beyond standard of care. If we run such comprehensive biomarker tests before the first-line treatment, it allows us to have a complete overview of all the therapeutic options available for a patient. It gives us the opportunity to choose the best treatment not only for the first line but also for all the other lines of therapy.
OncoDNA: Could you say a few words on your experience with OncoDNA comprehensive biomarker test?
Dr Shapochka: A couple of times, we have had patients diagnosed with a colorectal cancer that presented KRAS mutations. Thanks to OncoDNA comprehensive biomarker test we detected high TMB without any MSI, indicating that these patients would respond to immunotherapy. We also had another patient diagnosed with a colorectal cancer that presented PD-L1 expression. This patient benefitted from immunotherapy. Without comprehensive biomarker testing, we would not have been able to provide these patients with additional therapeutic options.