Why Tumor Profiling Matters: Real-World Examples

In our previous post on coverage gaps in tumor testing, we highlighted that 71% of health plans are more restrictive than the NCCN guidelines, limiting access to molecular profiling. This means many patients never receive the insights that could shape their treatment plan.

But what does this gap look like in practice? In this post, we’ll explore how tumor testing can completely reshape care in three common cancers: lung, breast, and colorectal.

Lung Cancer (Non-Small Cell Lung Cancer)

Non-small cell lung cancer (NSCLC) makes up about 85% of all lung cancer cases.¹ Within this group, tumor testing often reveals whether specific genetic mutations, such as EGFR, ALK, ROS1, or BRAF, drive the cancer.^2,3 These mutations are important because they are targetable with specific medications.

For example, patients with an EGFR mutation may receive a drug called osimertinib, which often works better than chemotherapy and causes fewer side effects.^1,2 Without molecular testing, a patient might miss out on this more effective and less toxic treatment option.

Breast Cancer

Breast cancer isn’t a single disease; it includes multiple subtypes. A key distinction is whether the tumor overexpresses a protein called HER2. About 15–20% of breast cancers are HER2-positive, meaning they grow more aggressively but can be treated effectively with targeted therapies like trastuzumab or pertuzumab.^4,5

Clinical trials have shown that adding trastuzumab to chemotherapy significantly improves survival for patients with HER2-positive tumors.⁵ On the other hand, HER2-negative cancers require a different approach, often involving hormone therapy or chemotherapy.⁴ This example highlights why knowing the molecular profile of a tumor is so important. It directly influences which therapies will and won’t work.

Colorectal Cancer

In colorectal cancer (CRC), KRAS mutations are a critical biomarker. Approximately 40% of CRC patients have a KRAS mutation, and research shows these patients do not benefit from EGFR inhibitors like cetuximab.^6,7 Without testing, a patient could receive an ineffective and costly treatment.

Molecular profiling can also reveal if a tumor is microsatellite instability-high (MSI-H). Patients with MSI-H tumors often respond very well to immunotherapies, which may not be considered otherwise.⁸ This is another way that testing ensures patients get access to the most effective and personalized care possible.

The Bottom Line

These examples show how tumor profiling turns a one-size-fits-all approach into precision medicine. By identifying the unique characteristics of a tumor, doctors can recommend treatments that are more effective, less toxic, and better matched to each patient’s cancer.

Yet as we shared in our previous post, 71% of health plans are more restrictive than the NCCN guidelines when it comes to covering tumor testing. That means many patients still don’t get the insights that could change their care.

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This is where Kadance makes the difference. Our precision care model ensures members have access to advanced tumor testing, closing the gap left by restrictive coverage policies. By coordinating testing and delivering actionable results, Kadance helps physicians and patients make informed decisions—so no one misses out on the therapies that could work best for them.

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References

¹Zhang, J., Pan, Y., Chen, J., Wu, Y., Hu, H., Wang, B., ... & Sun, Y. (2022). Mutation-tailored treatment selection in non-small cell lung cancer. Lung Cancer, 171, 69–77. https://doi.org/10.1016/j.lungcan.2022.07.007

²Drilon, A., Jenkins, C., Iyer, S., Schoenfeld, A., Keddy, C., & Farago, A. (2017). Beyond ALK and ROS1: RET, NTRK, EGFR, and BRAF gene fusions in lung cancer. Translational Lung Cancer Research, 6(5), 550–559. https://doi.org/10.21037/tlcr.2017.06.10

³Ouyang, W., Yu, Y., Cao, J., Zhang, J., & Wang, J. (2019). Clinical features and therapeutic options in non-small cell lung cancer. Frontiers in Oncology, 9, 1193. https://doi.org/10.3389/fonc.2019.01193

⁴Sheikh, A., Hussain, S. A., Ghori, Q., Naeem, N., Fazil, A., & Tirmazy, S. H. (2021). Trastuzumab for early-stage, HER2-positive breast cancer: A review of literature. Current Oncology, 28(4), 2927–2937. https://doi.org/10.3390/curroncol28040252

⁵Slamon, D., Eiermann, W., Robert, N., Pienkowski, T., Martin, M., Press, M., ... & Crown, J. (2011). Adjuvant trastuzumab in HER2-positive breast cancer. New England Journal of Medicine, 365(14), 1273–1283. https://doi.org/10.1056/NEJMoa0910383

⁶Allegra, C. J., Rumble, R. B., Hamilton, S. R., Mangu, P. B., Roach, N., Hantel, A., ... & Schilsky, R. L. (2013). Extended RAS gene mutation testing in metastatic colorectal carcinoma to predict response to anti–epidermal growth factor receptor monoclonal antibody therapy: American Society of Clinical Oncology provisional clinical opinion update 2015. Journal of Clinical Oncology, 34(2), 179–185. https://doi.org/10.1200/JCO.2015.63.9674

⁷Wang, H., Liang, L., Fang, J., Xu, J., & Zheng, J. (2021). Role of oncogenic KRAS in the prognosis, diagnosis, and treatment of colorectal cancer. Molecular Cancer, 20, 143. https://doi.org/10.1186/s12943-021-01441-4

⁸Lee, J., Kim, J., Park, S., & Kim, S. T. (2024). Immunotherapy for microsatellite-stable metastatic colorectal cancer: Current challenges and future directions. Current Oncology Reports, 26(4), 513–522. https://doi.org/10.1007/s11912-024-01583-w