By: Harala Halevi. Promoted content sponsored by Roche, a representative of Foundation Medicine in Israel
When a doctor identifies which mutations caused the cancer to develop and spread, he can better understand what the relevant treatment options are, and thus tailor the treatment personally to the patient. One of the technologies that enables personalized treatment is genomic sequencing, on which "genomic tests" are based. There are various genomic tests, with the most advanced that exists today being a comprehensive genomic test.
In contrast to routine genomic tests, which test a limited number of genes and mutations, a comprehensive genomic test can simultaneously identify a large number of mutations and other genomic changes in the tumor's DNA. In this way, the doctor gets a more complete picture of the molecular composition of the tumor. The information obtained increases the likelihood of locating treatable genomic changes and may also improve the chance of adapting a more precise treatment for the tumor.
Comprehensive genomic tests open a new window for personalized cancer treatments and in some cases make it possible to adjust targeted treatments, which would not have been taken into account without the test. However, despite the great hope for more accurate treatment, these tests are not suitable for everyone.
In which cases is a comprehensive genomic test not appropriate?
Early detection - A comprehensive genomic test is intended for diagnosed cancer patients only and is not used as a test for the early detection of cancer. Early diagnosis of cancer is carried out using different methods, such as imaging tests, manual doctor's examination and more, depending on the type of tumor. A comprehensive genomic test is used to detect molecular changes in a malignant tumor and is designed to adjust targeted treatment in cancer patients.
Absence of a doctor's recommendation for a genomic test - The cooperation between the doctor and the patient is one of the factors that can help increase the likelihood of a more successful oncology treatment, therefore the decision to perform the test should be made after an open conversation with the doctor about the continuation of the treatment. A comprehensive genomic test is suitable as a diagnostic aid in cases where the doctor recommends the necessity of this test, for example, in cases where there is a likelihood that the test can reveal relevant findings or additional treatment options.
Early stage cancer - Cancer patients with non-advanced or disseminated (non-metastatic) cancer, and their tumor is in an early stage, will often undergo surgical intervention and/or receive other treatment, but in many cases will not need targeted treatments. Therefore, comprehensive genomic testing is not relevant for these patients.
This test is also not used to plan future treatment, in case the tumor returns. Because cancerous tumors continue to develop and their genetic makeup may change over time, a test performed on a sample from the original early-stage tumor may not necessarily be relevant if and when the tumor returns or progresses.
Who are comprehensive genomic tests suitable for?
A comprehensive genomic test is intended for people for whom the doctor is trying to find additional treatment options. It is suitable for people with cancer that is in an advanced stage (grade 4), for people who have exhausted all standard treatments or for those who, according to the accepted guidelines, have a recommendation to test for several genomic changes.
A comprehensive genomic test is also suitable for newly diagnosed patients with a rare or uncommon grade 4 tumor, for which there is no treatment or for which existing treatment is limited, for patients with an aggressive grade 4 tumor that does not respond to standard treatments, and for people diagnosed with non-small cell lung cancer (NSCLC), with Advanced or widespread (metastatic) disease. A comprehensive genomic test is also suitable for patients who have a tumor of unknown origin, or when it is difficult to choose an appropriate treatment for them.
In any case, in order to perform a comprehensive genomic test, the treating oncologist must be consulted.
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The article is sponsored by Roche, the representative of Foundation Medicine in Israel
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