Next-Generation Sequencing Gives Your Treatment a Boost
- Singer and songwriter Sheryl Crow, 61, is an advocate for early breast cancer detection through mammograms after her own early-stage breast cancer journey. After a diagnosis, women are encouraged by SurvivorNet experts to inquire about Next-generation sequencing, which takes a deeper dive into the inner workings of your cancer.
- Next-generation sequencing (NGS) is a specific type of technology used for molecular profiling. It helps doctors better understand breast cancer tumors, what makes them function, and possible treatments to eradicate them.
- NGS is critical for patients with late-stage or metastatic breast cancer. NGS test results in metastatic breast cancer look for additional DNA mutations that may have an effective targeted therapy.
- NGS testing for metastatic breast cancer also involves bouts of re-testing of the tumor markers, which helps your doctor get a better sense of how your cancer is evolving.
Singer and songwriter Sheryl Crow, 61, discovered she had early-stage breast cancer after undergoing a routine mammogram. For women diagnosed with breast cancer, it’s important to ask your doctor about next-generation sequencing, especially during these early critical stages of your journey.
Next-generation sequencing (NGS) is a specific type of technology used for molecular profiling. According to Dr. Yara Abdou, a breast medical oncologist at UNC Lineberger Comprehensive Cancer Center, “(NGS) can simultaneously test a tumor for hundreds of genes or defects. And this information can help us with how to manage the disease.”
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Crow’s treatment involved a lumpectomy, which is a procedure that removes the cancerous area of the breast. After undergoing surgery and radiation, Crow’s went into remission.
While it’s unclear if Crow underwent any NGS testing for her breast cancer, we do know this approach helps doctors better understand the breast cancer tumors, what makes them function, and possible treatments to eradicate them.
Helping Patients Understand the Benefits of Next-Generation Sequencing
- Digital Guide With Dr. Katherine Scilla: Next-Generation Sequencing for Lung Cancer
- Digital Guide: Dr. Valsamo Anagnastou’s Overview of Next-Generation Sequencing
- Lung Cancer: How Oncologists Use Next-Generation Sequencing (NGS)
- The Cost Of Next-Generation Sequencing
- What’s it Like to Get Next-Generation Sequencing for Lung Cancer?
Molecular Profiling
“Molecular profiling involves the use of various technologies to understand the underlying characteristics of the tumor found in your cancer by giving us specific information on the molecular and genetic makeup of that tumor,” Dr. Abdou explains.
These features or characteristics refer to DNA, RNA, or protein alterations or mutations in your tumor. Those changes can help give you and your doctor a better idea of the following:
- Whether you would benefit from certain treatments and targeted therapies.
- Suppose your cancer is likely to come back.
- Whether other family members may be at risk for certain kinds of cancer.
- If you qualify for potential clinical trials.
There are several tests you may encounter, depending on where you are getting treatment and what you are getting treatment for. Here are some of the common ones currently on the market:
- FoundationOne®CDx looks at 324 genes in solid tumors and says results can take up to 12 days. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB) to help inform immunotherapy decisions.
- OmniSeq Insight provides comprehensive genomic and immune profiling for all solid tumors. It looks for 523 different genes. Test results include microsatellite instability (MSI) and tumor mutational burden (TMB), as well as PD-L1 by immunohistochemistry (IHC).
- Cobas EGFR Mutation Test v2 identifies 42 mutations in exons 18, 19, 20, and 21 of the epidermal growth factor receptor (EGFR) gene. It is designed to test tissue and plasma specimens with a single kit, allowing labs to run tissue and plasma simultaneously on the same plate.
Does Next Generation Sequencing Help Patients with Advanced or Metastatic Breast Cancer?
SurvivorNet experts recommend breast cancer patients diagnosed with early-stage breast cancer to ask about NGS testing. However, this is not considered standard-of-care for early-stage breast cancer. On the other hand, NGS is critical for patients with late-stage or metastatic breast cancer, such as “Beverly Hills 90210” actress Shannen Doherty, 52, whose cancer has spread beyond the breast and toward her brain.
NGS test results in metastatic breast cancer look for additional DNA mutations that may have an effective targeted therapy.
“We usually recommend a repeat biopsy of the tumor from a spot where the cancer has spread. And that’s, of course, if it’s safe to biopsy that spot,” Dr. Abdou says. “Examples of such spots would be lung, liver, and bone. Those are examples of where we would obtain a biopsy in metastatic disease. The biopsy is really to confirm that the cancer is indeed metastatic breast cancer.”
Re-testing the tumor markers is also very important. Dr. Abdou continues:
“We also like to repeat the tumor markers, which are the receptors, including estrogen, progesterone, and HER2, because while in most circumstances the tumor markers remain the same as the primary tumor that started in the breast, in some circumstances, these markers change.”
Doing another biopsy and re-testing the tumor markers gives your doctor a better sense of how your cancer has evolved.
Questions to Ask Your Doctor
If you find yourself struggling with a diagnosis or helping a loved one cope with their emotions, consider asking your doctor the following questions:
- How can I go about improving my outlook/mental health?
- Are there any activities I can do to encourage positive feelings?
- When should I seek other interventions if I’m still struggling?
- What are the steps to finding a different therapist if the one I’m using is not working out?
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