Imagine a diagnosis of pancreatic cancer. Biomarker testing identifies a targeted medication therapy. Soon after, there’s no more cancer.  Thomas VanderMeer, MD, has seen this happen. “We’ve had patients who had the cancer completely eradicated,” he says. 

VanderMeer is a pancreatic surgeon and the interim director for the Upstate Cancer Center. He’s grateful Gov. Kathy Hochul signed a law requiring health insurers in New York to pay for life-saving cancer biomarker testing, which makes targeted therapy possible. It took effect Jan. 1, 2025.

Biomarkers became a tool for cancer care providers starting in 2001, when the Food and Drug Administration approved the drug Gleevec to target a specific protein on a cancer cell. VanderMeer says the drug was incredibly effective against a couple of rare cancers. 

“Since then, molecular targets and their biomarkers have been identified in many different cancers with numerous new drugs created to interfere with cancer cell growth,” he says. “And now there are so many potential molecular targets for treatment that testing is done on a panel of over 300 molecular alterations.”

Today, the cancers with molecular targets for treatment are most commonly seen in non-small cell lung cancer, melanoma and breast and colorectal cancers. “Increasingly, we are finding that these new drugs work against more and more types of cancer,” VanderMeer says.

Targeted therapy is less toxic than traditional chemotherapy, whose agents interfere with the growth of cancer cells and other cells throughout the body. The targeted therapies modify specific molecular processes that are unique to cancer cells and interfere with cellular signals that cause cancer cells to grow or to limit our own body’s immune response to fight the cancer.

“As a result, there’s much less collateral damage to normal cells because the activity of these drugs is so much more specific and limited,” explains VanderMeer. He says newer treatments are designed to reprogram a patient’s immune cells to kill their cancer.

Before the new law, a third of health insurers would not pay for biomarker testing, according to Michael Davoli, the American Cancer Society’s senior government relations director for New York. New York was the 13^th state to enact comprehensive biomarker testing.

One of the exciting things about the New York law is that it’s not a cancer bill, per se. “It’s actually disease agnostic,” Davoli explains. “While biomarker testing is primarily being used in the treatment of cancer currently, there's research being done in a whole host of different medical conditions—everything from mental health issues to heart disease, different neurological conditions, even Parkinson's and ALS (amyotrophic lateral sclerosis.) There's research being done on how it can be used for the treatment of those diseases.

“What this bill explicitly says is, if the science shows that biomarker testing can be used to treat that disease, then it should be covered by the law, and the testing should be covered by your insurance.

What is a biomarker?

A biomarker is a sign that something is happening in our bodies. In the case of cancer, biomarkers are molecules that indicate if cancer is present, what abnormality is causing the cancer to grow, how active it is and how it will respond to different types of treatment. Some biomarker testing is done with blood tests, and some require tissue from a biopsy.

This article appears in the Winter 2025 issue of Cancer Care magazine.