The importance
of complete
molecular
profiling

The importance of complete molecular profiling

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:

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Diagnostic biomarkers detect cancer and identify the specific disease

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Predictive biomarkers are used to help select the best treatment and predict patient response

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Monitoring biomarkers help to track a patient’s response to therapy

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Diagnostic biomarkers detect cancer and identify the specific disease

WHEN to test for biomarkers

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.

HOW to test for HRAS and PIK3CA

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:

Biomarker

HRAS mutations

PIK3CA mutations and amplifications

HRAS overexpression

Assay

FoundationOne® Liquid

Tempus xT

Caris Molecular Intelligence® CANCERPLEX®

Paradigm PCDx™

Guardant360®

FoundationOne® CDx

Oncomine Comprehensive Assay

PGDx elio™

No commercial panels. Send to lab for IHC analysis.