Commentary: Biomarker testing set the tone for my survivorship

By Sydney Barned

The writer is an internal medicine doctor and hospitalist based in Anne Arundel County. In 2017, she was diagnosed with stage 4 lung cancer.

Growing up, I loved to dance and took every opportunity to move my body, no matter the beat. Something about the structure of a choreographed dance gave me immense calm; I loved knowing that if I performed a pirouette and followed it up with a plié I would create something beautiful. I still love to dance but, six years ago at 33-years-old, noticing a waning capacity to move my body and take in air, I encountered what would be my most challenging routine yet: stage IV lung cancer. Thankfully, I was offered biomarker testing at the time of my diagnosis; the results have guided my treatment plan and opened up doors to targeted therapies. Biomarker testing enabled my oncologists to choregraph a treatment plan that has sustained me for six years and counting — longer than I thought possible.

When my oncologist told me about biomarker testing, I was intrigued. At the time, I was an Internal Medicine resident and familiar with the tenets of precision medicine, employing it in my own practice. I knew that it could offer a window into my cancer through the analysis of my tumor cells. From there, my oncologists could personalize my treatment, matching me with targeted therapies that could best attack my disease. I did not, however, realize that it would give me a new lease on life.

The results of my testing indicated that I was positive for the anaplastic lymphoma kinase (ALK+) biomarker, which qualified me for a targeted therapy, crizotinib. I would have to take this medication every day for the rest of my life, but it would enable me to forgo a broader chemotherapy. Since receiving my diagnosis, I dreaded the prospect of chemo and was relieved to avoid it. Because of the information gathered from my biomarker testing, I learned that I was a good fit for this targeted treatment that would enable me to maintain a ‘normal’ life despite my diagnosis. My disease wouldn’t define me.

For five years, crizotinib enabled me to keep practicing medicine, remain present with family and friends and maintain my quality of life; however, last September, I learned that my disease had metastasized to my brain. Though incredibly difficult news to receive, biomarker testing, again, helped to keep me calm, directing my oncologists to prescribe an alternative targeted therapy, alectinib. I have been on the new medication for eight months now and have regained the ‘normal’ life that I cherished.

Biomarker testing opened the door to treatments that have dramatically extended my life and improved the quality of my life immensely. Data indicate that this game-changing testing has a resoundingly positive effect, reducing many patients’ risk of death in otherwise hard-to-treat cancers. Not only do biomarker tests inform the treatment of current cancer patients, but they also activate new treatment opportunities for future cancer patients. With 37 of the 62 oncology drugs launched in the past five years requiring or recommending biomarker testing prior to use, it’s clear that biomarker testing unlocks possibilities for patients and is a vital, active ingredient in ongoing cancer research. With the recent passage of House Bill 1217/Senate Bill 805, thousands more Marylanders will have access to the lifeline of biomarker testing.

That is because, until now, many Marylanders covered by state-regulated health plans, including Medicaid, could not receive coverage for the comprehensive biomarker testing they need to best face diseases like cancer. I was lucky to have my biomarker testing covered by my insurance, but other patients have been missing out. With Gov. Wes Moore’s recent signature on this law, many private insurers and Medicaid will now be required to cover biomarker testing for patients who need it.

I don’t know how my story would’ve unfolded if I hadn’t been able to get comprehensive biomarker testing. Everyone deserves the same opportunity as me. The recent victory in Annapolis will allow more residents in our communities to access this game-changing testing that allowed me to find the treatments that have saved my life.

I like to think of biomarker testing as the chorography for my dance with cancer; it gives me and my doctors direction and allows me to focus on my movement, my survivorship. The news of my metastasis was just an intermission in my routine, which has countless scores filled with joy and laughter left to come. I am confident that I will never stop dancing — biomarker testing gave me that.