BY AMBER SMITH

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 lifesaving 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 preferred because it’s less toxic than traditional chemotherapy, whose agents interfere with the growth of cancer cells as well as 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 own 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. He says New York was the 13th state to enact comprehensive biomarker testing, and efforts are underway in all remaining states to enact similar laws.

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.

“So, 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, a lot of different neurological conditions, even Parkinson’s and ALS (amyotrophic lateral sclerosis), there’s research being done on biomarker testing and 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."

 

Hear VanderMeer and Davoli discuss the promise of biomarkers on "The Informed Patient" podcast.

 

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