One question every lung cancer patient should ask – especially Black or African American patients
What is my biomarker?
A newly diagnosed lung cancer patient should ask this question before starting treatment. Why? Because the answer to this question can change the odds and the choices for your personalized treatment plan, especially for Black or African American patients.
Black and African Americans must ask their doctors, “What is my biomarker?” to ensure they receive the latest targeted therapy treatment that is applicable. Hear from Dr. Sydney Barned and Brandi Bryant in this episode as they discuss their care and what a difference it made in knowing their biomarkers. And maybe even more importantly, they are advocating that every black or African American should ask that question, “What is my biomarker?”
There are more options for treating lung cancer and they want to make sure every black or African American patient, like everybody, else gains access to that full range of options.
Dr. Sydney Barned, a hospitalist at Ann Arundel Medical Center in Annapolis, Maryland, a lung cancer patient, and a member of the LCFA Speakers Bureau
Brandi Bryant, a lung cancer patient, and a member of the LCFA Speakers Bureau
Dr. Raymond Osarogiagbon, Chief Scientist for Baptist Memorial Health Care, Director of Baptist Cancer Center’s Multidisciplinary Thoracic Oncology Program and Thoracic Oncology Research Group, and Principal Investigator of Baptist’s Mid-South Minority-Underserved Consortium initiative, NCORP, in Memphis, Tennessee
7 Things to Know About Biomarker Testing
Biomarker testing can also be called molecular, genomic, or genetic testing. Here are 7 Things you should know about biomarker testing and why it may be beneficial to your treatment.
Why do Biomarkers Matter in Lung Cancer Treatment?
Minority and underserved communities must advocate for themselves to get the best treatments, especially treatment that can increase the quality of their lives. Guest Dr. Osarogiagbon dives into not only the importance of asking, “what is my biomarker?”, but why it is essential that Black and African Americans make this question a priority. Thanks to lung cancer research, he’s really excited that lots of biomarkers have been discovered to help doctors split what used to be a single disease, into a disease of many different bits and of different sizes.
Understanding biomarkers now allows doctors to predict how the cancer is going to behave. And then determine what treatment is most likely to benefit the patient, in terms of surviving lung cancer – and the quality of life, in response to cancer treatment.
“So, you go from 4% to 6% five-year survival, to up to 60%, if you get the right treatment for right cancer. As with ALK mutated lung cancer, so with some of the other subsets, the EGFR mutated lung cancers, the ROS1 mutated lung cancers, the BRAFF mutated lung cancers, the MET exon 14 mutated lung cancer, all… There are at least nine subsets of biomarker-driven lung cancers, and that continues to change all the time. So, that’s why it’s vital that we get tested, so we know which treatment would benefit us.”
– Dr. Raymond Osarogiagbon
Targeting Their Specific Biomarker
Biomarkers are a very important part of Dr. Barned and Brandi’s lung cancer story. These lung cancer patient/advocates and members of LCFA’s Speakers Bureau share their stories about their diagnosis, their care, and what a difference knowing what their biomarker has made in their treatment.
Each lung cancer is pretty unique, and through biomarker testing, you can find specific traits that can tell you how your lung cancer works. For instance, Brandi and Dr. Barned have the ALK /biomarker. But there are other biomarkers, such as EGFR and KRAS, that are drivers of other lung cancers. But, if that driver, that mutation, that biomarker, is identified, then there may be a targeted therapy. For Dr. Barned and Brandi, that is a pill.
“Thankfully, I was found to have a biomarker, so I am ALK-positive. I’m able to take targeted therapy that just pinpoints that mutation.”
Dr. Sydney Barned
What Does Targeted Therapy Looks Like?
Although Brandi and Dr. Barned are both ALK-positive and being treated by targeted therapy, they are each on different drugs for managing their lung cancer. Brandi takes four pills in the morning with food and four pills at night. She says the side effects are minimal – a little more tired – but she just keeps moving. One would have no idea she is fighting stage four cancer.
“Thanks to my biomarker testing, much like Sydney, I was able to take a targeted therapy when I was at stage 4, and I’ve had a great quality of life for the past four years. I’ve been able to watch my kids grow up, and graduate. I mean, they’re not all grown, but I’m just watching them complete these milestones, and that’s really something I’m quite thankful for, that the research has made it to this point because whenever I was diagnosed, the drug that I’m on had just been approved.”
- Brandi Bryant
Dr. Barned takes a pill twice a day. She’s been taking that same targeted therapy for five years now with a wonderful response. She feels she has a better quality of life versus doing traditional therapies, such as chemotherapy or even immunotherapy.
These stories really bring home how important it is for lung cancer patients to ask the right questions, like, “What is my biomarker?” This is an important message to get out, especially to those in underserved communities who are diagnosed with lung cancer.
Addressing the Disparities in Lung Cancer Care
Disparities also are the result of broader social and economic inequities in society—such as lack of access to health care, education, and quality food; economic instability; and limited social and community support—that disproportionately affect people of color. As Dr. Osarogiagbon explains, “Unfortunately, biomarker testing is still relatively new. Doctors and healthcare systems are still learning about the importance of biomarkers. And like anything new, it takes a while for everybody to be aware, for everybody to gain access.”
And as usual, the poor, the relatively underinsured, and the less well educated oftentimes get left behind with these innovations, such as biomarker testing. And this often includes black communities where patients go to smaller practices or community-based practices. These facilities tend to provide care for relatively underinsured people, so they also lack the infrastructure to get testing done.
Biomarker testing is relatively new and new things tend to be somewhat more expensive. So, people who are underinsured may find it harder because some insurance companies may be more resistant to providing coverage for the types of biomarker tests that doctors are increasingly demanding for their patients.
Determining the Right Treatment Using Biomarker Testing
The role of chemotherapy as a first-line treatment by itself in lung cancer is actually shrinking fast because every six months, a new biomarker-driven treatment is approved by FDA. Dr. Osarogiagbon uses the analogy that lung cancer treatment is like a pizza with multiple slices.
“It used to be the whole pizza was chemotherapy. It’s now, by my estimation, about 25% of the whole pizza. So, the challenge again is the other slices of pizza. Some are thinner than others.