Have I had all the biomarker tests I should have for my cancer?
The short answer
Biomarker and genomic testing determines which targeted therapies and clinical trials you qualify for. Because the right tests depend on your exact cancer type, stage, and prior treatment, missed or incomplete testing is common and worth confirming.
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Who this applies to
Anyone recently diagnosed, weighing a treatment decision, or whose cancer has progressed. Biomarker results can change which treatment is recommended, so a gap here can change your options.
What biomarker testing is and why it matters
Biomarkers are features of your specific tumor (gene mutations, proteins, or other molecular markers) that predict how the cancer behaves and which treatments are likely to work. Two people with the same cancer type can need completely different treatments based on their biomarkers. Testing is what unlocks targeted therapies and many clinical trials. Without it, those options stay invisible.
What complete testing usually covers
The specific panel depends on your cancer type. Standard-of-care biomarkers include, per NCCN and NCI: ER, PR, and HER2 in breast cancer; EGFR, ALK, ROS1, KRAS, BRAF, and PD-L1 in non-small cell lung cancer; RAS, BRAF, and MSI/MMR in colorectal cancer; and BRCA1/2 in ovarian and prostate cancer. When standard single-gene tests are negative, or when cancer progresses, broad genomic profiling (a next-generation sequencing panel) can surface options the standard panel misses. Tumors also evolve, so testing done at diagnosis may be worth repeating after progression.
When a gap matters most
Incomplete testing is most consequential in metastatic or progressed disease, in rare subtypes, and any time you are choosing between a targeted therapy, immunotherapy, or a clinical trial. If your treatment plan was set without the biomarkers above, it is worth asking why.
Questions to ask your oncologist
- Which biomarkers have been tested on my tumor, and which have not?
- Would broad genomic profiling (NGS) change the options on the table for me?
- Should we re-test now that my cancer has changed or progressed?
- Are there targeted therapies or trials I would only qualify for with additional testing?
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Upload your records and OpenCancer reads them against the standard testing for your specific diagnosis, then flags which recommended biomarker tests appear to be missing, so you know exactly what to ask about.
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Written by OpenCancer’s science team and grounded in NCCN and NCI guidance. Independent medical review by our clinical team is in progress.
For informational purposes only. This page is grounded in published guidelines and is not medical advice. Always consult your oncologist or care team before making treatment decisions.