A Look at Cancers Where Biomarkers Are Needed

New treatments have extended life spans in certain cancers, but there remains a need for biomarkers in some that can help identify the best therapy for a patient, said Susan Wescott, RPh, MBA, senior director of managed care pharmacy, Mayo Clinic.

This transcript has been lightly edited for clarity.

Transcript

What are some areas where biomarkers are desperately needed but haven’t been identified yet? How do outcomes in those disease states compare with diseases with identified biomarkers?

Cancer care has been evolving and we now have great treatment options for breast cancer and for prostate and we're improving the lifespan of those people. Cancer is becoming a chronic condition rather than a death sentence in some cases. I've asked a couple of colleagues this question today to get some feedback from them, “Where do you see the gaps?” and the answers that came back were, first of all, cancers of the brain. If we think about our glioblastomas, now the blood-brain barrier, it's harder for drugs to cross into there. It's harder to treat these cancers. But we don't have good biomarkers to identify and do early detection or to identify which therapy would work best in those patients.

Another area is colorectal cancer. I think this is an area where we're going to see increasing incidence in our population at large and definitely could use more information that could be brought by biomarker testing.

And then lastly, a couple of big cancers, ovarian and prostate come to mind, where we do have some biomarkers available, but they don't give us all the information we need to optimize that patient’s journey. Thinking about ovarian, we know there's a tumor there, but is it benign or malignant? And often we have a surgical intervention there to figure that out. If a biomarker could provide more information, it would be meaningful. Similar with PSA [prostate-specific antigen] being the gold standard for tracking prostate cancer, it really doesn't give us all the information we'd like to have. So, a couple of other big cancers that could use advances in addition to our rare cancers.

How can the identification and use of biomarkers drive down costs in the long run?

This is a little counterintuitive, if you come at the problem de novo that I'm going to spend a lot more money to do this next-generation sequencing testing, NGS, and what am I going to get back for that? So, I'm a person on the medical benefits side. They might use a PD-L1 depending on the results of the testing, but they might use an outpatient oncology drug from a specialty pharmacy depending on the results. I think the overall cost of care has been clearly shown to be lower when biomarker testing is done, certainly in non–small cell lung cancer where we have a robust availability of different biomarker tests that lead to truly better outcomes.