Realizing the Full Potential of Diagnostic Testing in Cancer Care

Eli Lilly and Company  | July 14, 2020

This article comes from Anthony (Nino) Sireci, M.D., vice president, diagnostics development and medical affairs, Loxo Oncology at Lilly.

The promise of personalized medicine in oncology can be fully realized only through the adoption of comprehensive biomarker testing to identify patients with targetable alterations in their cancers. Despite progress toward improving access to testing, we do not yet live in a world where all patients with advanced cancers receive high-quality and broad-based genomic profiling of their tumors to aide in the selection of appropriate therapies. 

I had the opportunity to speak on a panel at the 2020 Community Oncology Alliance (COA) Annual Conference, where we discussed the state of genomic testing in oncology and how we would like to see it evolve.

There is no question that broad-based biomarker testing is the right approach to evaluate a patient with advanced cancer, particularly a cancer for which there are multiple targeted therapies available. However, from ordering the right, high-quality test to interpreting the results of genomic profiles and properly consenting patients on the financial liability introduced by biomarker testing, ordering physicians treating cancer struggle to appropriately test their patients.

Lilly Oncology and Loxo Oncology at Lilly are working to bridge the gap between patients, providers and diagnostic testing in driving high-value cancer care. We are committed to advancing this integral component of cancer diagnosis and treatment, irrespective of the biomarker of interest or the relevant targeted therapeutic.

One way we are working to increase accessibility of diagnostic testing is by advocating to move biomarker testing from centralized labs into local laboratories closer to where the patient is receiving care. This will enable an open line of communication between molecular pathologists and the patient care team. Increased communication can help with assay selection and results interpretation, and can improve the turnaround time of these tests.

Additionally, as a lung cancer survivor on our panel at COA highlighted, uncertainty surrounding insurance coverage for biomarker testing can be a barrier to access. While there have been improvements in the coverage of biomarker testing for Medicare beneficiaries with solid tumors, the coverage is limited to one testing event and is ambiguous at best. Lilly is a strong voice in the ongoing discussion on coverage for biomarker testing along with partners in the pathology and oncology communities.

It is important to realize that, despite all of the operational, economic and regulatory barriers standing in the way, the momentum of oncology care is in the direction of increasingly targeted therapies. One of my co-panelists, Dr. Martin Dietrich, medical oncologist at Florida Cancer Specialists, said it best when he called genomic tests “the center point of progress in modern oncology.” We owe it to patients to continue to tackle the issues currently standing in the way of quick, accessible profiling in cancer treatment. This is not optional or add-on information, but foundational data needed to guide any oncology treatment plan.