R. Steven Paulson, MD, physician, Texas Oncology, discusses the importance of molecular testing in the era of precision medicine in oncology.

It is challenging for general oncologists to keep up with all of the constant treatment advancements in every malignancy, Paulson explains. All patients with advanced tumors, especially those defined as stage ≥III, should be considered for biomarker testing, says Paulson.

Texas Oncology utilizes tools that help guide the decision-making process on molecular testing in terms of laboratory tests, and help determine what tests should be ordered and what tests are actionable upon patients. Physicians and researchers at Texas Oncology apply a model to both order the appropriate test for diagnosis and, in particular, to use that data to maximize the benefit of the patient, concludes Paulson.

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R. Steven Paulson, MD, discusses the importance of molecular testing in the era of precision medicine in oncology.
 

Dr. Paulson on the Importance of Biomarker Testing in Oncology

R. Steven Paulson, MD, physician, Texas Oncology, discusses molecular testing in oncology.

Over the past 2 years, the importance of broad molecular testing across tumor types has become more apparent, says Paulson. Tumor mutational burden, microsatellite instability status, and specific alterations like 

 fusions, have tumor agnostic indications for broad molecular profiling.

Patients with stage III or stage IV cancer should undergo molecular testing to optimize treatment, says Paulson. Patients with an actionable aberration may receive targeted therapy and be spared ineffective treatments, adds Paulson.

Precision medicine has shifted treatment to target specific genetic alterations within the tumor rather than the tissue of origin, concludes Paulson.

R. Steven Paulson, MD, discusses molecular testing in oncology.

Dr. Paulson on Molecular Testing in Oncology

R. Steven Paulson, MD, physician, Texas Oncology, discusses the utility of liquid biopsies versus tissue biopsies.

Although tissue biopsy remains the gold standard in oncology, there may not be enough available tissue to perform a biopsy, explains Paulson. In these cases, a patient may need to undergo an invasive procedure to retrieve more tissue for testing.

Alternatively, a liquid biopsy may alleviate the need for an invasive procedure since it only requires a blood draw, says Paulson. A positive result with a liquid biopsy is relatively reliable; however, a negative test result should not be considered definitive.

Additionally, the turn-around time for a liquid biopsy is faster than a tissue biopsy. Therefore, if a liquid biopsy is positive, patients can begin targeted therapy earlier. However, the interpretation of liquid biopsies requires some standardization, concludes Paulson.

R. Steven Paulson, MD, discusses the utility of liquid biopsies versus tissue biopsies.

R. Steven Paulson, MD

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Dr. Paulson on the Importance of Biomarker Testing in Oncology

Dr. Paulson on Molecular Testing in Oncology

Dr. Paulson on the Utility of Liquid Biopsies Versus Tissue Biopsies