Cancer researchers found that some cancers grow due to a genetic change that develops over a person’s lifetime. By understanding whether there are changes in specific genes, a colorectal cancer treatment plan can be developed to include drugs that target these genetic changes. The Blue Ridge Cancer Care oncologists are dedicated to delivering precision medicine to our patients.
What is Biomarker Testing?
Biomarker testing, also called molecular testing or tumor profiling, examines cancer cells removed during a biopsy or surgery to identify specific genetic mutations, protein changes, or other molecular features. In some cases, a blood test known as a liquid biopsy may also provide useful molecular information.
These biomarkers influence how the cancer behaves, how aggressive it may be, and which treatments are most likely to be effective. Colorectal cancer treatments will vary from patient to patient, even if they have the same stage of cancer, if their genetic characteristics are different.
Types of Biomarker Tests for Colorectal Cancer
Biomarker testing helps us better understand the biology of colorectal cancer and tailor treatment accordingly. These tests may assist with diagnosis, help monitor for recurrence, and evaluate how well a treatment plan is working. At Blue Ridge Cancer Care, we focus on the biomarker tests that most directly impact treatment decisions and long-term management.
Genetic Biomarker Testing
Genetic biomarker testing analyzes the DNA within cancer cells to identify mutations or molecular changes that may be driving tumor growth. As research continues to advance, the number of genes that can be tested continues to expand. If a specific mutation is found, your oncology team may adjust the treatment plan to better target that alteration.
Several genetic biomarkers are commonly evaluated in colorectal cancer.
- BRAF is a gene involved in regulating cell growth and division. When mutated, it can lead to more aggressive tumor behavior and may influence treatment planning, particularly in advanced disease.
- KRAS plays a critical role in controlling cell growth signals. When KRAS is mutated, the signaling pathway that regulates cell growth becomes disrupted, leading to uncontrolled cell division. KRAS status is especially important when considering certain targeted therapies.
- NTRK gene fusions occur when two genes abnormally join together, creating signals that promote cancer cell growth. Although uncommon, identifying an NTRK fusion can allow for highly specific targeted treatment options.
- HER2 alterations can also be present in some colorectal cancers. When overexpressed or amplified, HER2 can contribute to rapid tumor growth and may influence targeted therapy decisions.
Additional genes may be evaluated depending on the stage of cancer and individual clinical factors. Genetic testing is especially important in metastatic colorectal cancer, where treatment decisions are often guided by molecular findings.
Protein Biomarker Testing
Some biomarker tests evaluate proteins rather than genetic mutations. One of the most widely used protein biomarkers in colorectal cancer is CEA (carcinoembryonic antigen).
CEA is a protein that may be elevated in patients with colorectal cancer. While it is not typically used alone to diagnose cancer, it is commonly used to monitor treatment response and detect possible recurrence after therapy. CEA levels are interpreted alongside imaging studies and clinical findings to provide a more complete picture of the disease.
Additional Biomarker Considerations
Beyond genetic and protein testing, other tumor characteristics may influence treatment planning.
- Tumor sidedness refers to whether the cancer began on the right or left side of the colon. Research has shown that right-sided and left-sided colon cancers can behave differently and may respond differently to certain treatments. This information can help refine therapy choices.
- Tumor signaling pathways describe how cancer cells communicate and grow. Testing may evaluate pathways such as PD-1/PD-L1 or tumor mutational burden (TMB), which can help determine whether immunotherapy may be beneficial. The Wnt signaling pathway is another area of active research in colorectal cancer and may become increasingly relevant as treatment options continue to evolve.
Treatment Based on Biomarker Test Results
Specific targeted therapies or immunotherapies may be included in the treatment plan if a biomarker test is positive for a specific genetic change or protein. Our oncologists will discuss their treatment plan recommendations during your consultation, explaining each therapy and the order they will be given.
Precision Medicine for Colorectal Cancer in Southwest Virginia
At Blue Ridge Cancer Care, biomarker testing allows us to move beyond a one-size-fits-all approach. By understanding the specific molecular features of your tumor, we can design a treatment plan tailored to your individual diagnosis.
Schedule a consultation with our oncologists to find out what is right for you.
