My Experience with Biomarker Testing

In April 2014, I was diagnosed with stage IIIb lung cancer. Being a new cancer patient, I did not know how to navigate this new diagnosis and I am thankful to have been seeing an oncologist that did. I moved my care from my local hospital where I heard the words “you have cancer” to a leading cancer university in Chicago.

You will hear these terms -- biomarkers, mutations, molecular or genomic testing, and so on. They all mean essentially the same thing and that is determining what is driving your cancer. I have learned so much in these past few years since being diagnosed with lung cancer. There are many terms and phrases that you will learn along the way.

Testing my tumor

In lung cancer, there are a few bigger biomarkers and a bunch of smaller ones. I was diagnosed with EGFR (epidural growth factor) lung cancer. There is also ALK (anaplastic lymphoma kinase), ROS1, and RET, just to name a few.

In the beginning, I underwent two bronchoscopies. The first at my local hospital and the second at the cancer center in Chicago. The first hospital did not get enough samples so therefore I had two. My new oncologist unbeknownst to me sent a sample of my tumor out for testing.

My mutation opened more treatments options

I was told that I had lung cancer and EGFR lung cancer in the same appointment. When I was told I had cancer they did not know what kind and was one of the main reasons I sought out different care. My oncologist told me that I had lung cancer and that it was EGFR mutated. I remember thinking that this was bad and almost started crying! She then explained that this opened different treatment options for me and that I would not have to start with chemotherapy.

This was exciting news! I started on a targeted therapy medication and was sent home to come back in one month for scans to see how it was working.

High MET amplification

I had a chest CT scan as well as a heart scan. The chest CT showed that the cancer was growing, and the heart scan showed that there was fluid around my heart. I also had a pulmonary embolism that was also increasing in size. All bad news, I started chemotherapy promptly. This will prove to be effective for about 5 months before needing to make some more decisions. I remember thinking that this was normal and that I would be jumping from treatment to treatment a lot. I did not realize at the time that you could get months or even years out of treatment.

My oncologist gave me three options and while I do not remember them all we decided to have another bronchoscopy and have the sample sent out for a wider range of biomarkers. This sample came back with a high MET amplification. This is called a resistance mechanism and is usually found after a targeted therapy has been taken.

Consider myself lucky

I have considered myself lucky since being diagnosed with both EGFR and MET amplification. I have participated in two clinical trials and I am currently only on one targeted therapy medication. I participated in the ABBV-399 trial and it was effective enough for my oncologist to deem me no evidence of disease in 2019.