There are many biomarkers that can play a role in HNSCC so it is important to test for different biomarkers. Even after initial testing, patients should be routinely tested with a full molecular workup following disease progression in order to detect relevant biomarkers. Biomarker testing can help guide you throughout different stages in a patient’s treatment:
In patients with HNSCC, it is important to test for biomarkers, such as HRAS and PIK3CA, upon both locally advanced or metastatic diagnosis to determine the appropriate treatment path including current investigational clinical trials are actively enrolling for these populations.
Even after the initial testing, patients should be tested at recurrence following disease progression. Common chemotherapies, such as cetuximab, are known to alter key mediators of tumor growth, which means that gene alterations could emerge in any line of treatment.
In a study of 46 HNSCC patients, 6 of 13 patients with progressive disease during cetuximab-based treatment showed evidence of acquired RAS mutations. Three of the 6 acquired mutations were HRAS mutations.
Biomarker testing can help you to discover cancer drivers and determine the best course of action for your patients with HNSCC. Early next-generation sequencing (NGS) can be used to uncover HRAS mutations and PIK3CA mutations and amplifications, and immunohistochemistry (IHC) can be used to determine HRAS overexpression.
Commercially available genomic panels include:
PIK3CA mutations and amplifications
Caris Molecular Intelligence® CANCERPLEX®
Oncomine Comprehensive Assay
No commercial panels. Send to lab for IHC analysis.