One of the biggest challenges in treating cancer is that each one can behave differently to the next. Will it grow fast, or slow? Will it spread to other organs or not? Might it come back after therapy?

Quick facts about genomic tests

• A test that looks at gene activity in your cancer cells
• Predicts how your cancer might progress 
• Helps your doctor together with you to decide the right treatment for you 

Genomic testing looks inside cancer cells at their genes to answer some of those questions. It’s a valuable method that enables your doctor in selecting the treatment most likely to be effective for your specific cancer in collaboration with you.

What is a genome?   

The genome is all the DNA inside a cell. Your DNA is like a long, twisted ladder carrying hereditary information in segments called genes. If stretched out, it would be about 2 meters long. It works as a set of instructions telling each cell how to behave.

Cancer starts with mistakes in the genome, called mutations. When mutations happen in regions of the genome responsible for growing, the cell might start to divide and grow uncontrollably, which is cancer.

What is genetic testing for cancer?

Genomic and genetic tests both look at genes, but they play very different roles in what they can tell us about cancer. 

Genetic cancer testing examines a person’s DNA for mutations, specifically looking at genes related to cancer. These tests help estimate the risk of developing certain types of cancer or identify inherited conditions. 

A well-known example is the test for the breast cancer genes BRCA1 and BRCA2. Women with a BRCA mutation have, among other risks, a significantly increased risk of breast and ovarian cancer, while men with a BRCA mutation have, for example, a higher risk of prostate cancer.

Diagnostic genetic tests: Look for the cause of an existing condition, like changes in the BRCA genes for breast and ovarian cancer.

Predictive genetic tests: This test is for people without disease. It identifies genetic changes that may increase the risk of developing an inherited disease in the future. 

Typically, a blood sample is taken for a genetic test. The DNA is analyzed in a lab to look for changes that increase the risk of cancer 

What is genomic testing for cancer?    

Unlike genetic tests that look for gene mutations, genomic tests examine how active certain genes are in a tumor (gene expression). This helps doctors to understand the tumor’s unique features and to choose the best treatment. 

In breast and prostate cancer, genomic tests can help doctors to decide if a tumor is likely to grow quickly and if it might respond well to more intense therapy.

Genomic testing helps predict 

• How aggressive the cancer might be 
• Whether it could respond to certain treatments 
• How likely it is to spread to other organs

Before genomic tests, doctors could predict a cancer’s behavior by examining the size, cell appearance, or spread. This information is still important. 

Genomic testing adds an extra layer of detail by analyzing the genomic fingerprint of cancer cells. Some genomic tests also include the cancer’s size and spread to provide a more accurate prediction, while others do not.

Difference between genetic and genomic testing 

The terms “genetic test” and “genomic test” may sound similar, but the tests play very different roles in what they can tell us about cancer.

Genomic test	Genetic test
Looks at tumor samples (cancer cells)	Looks at blood/saliva samples (normal cells)
Looks into the activity of specific genes in the tumor(sometimes combined with the cancer’s size and spread).     Can inform your doctor about:    Cancer aggressiveness:   How quickly your cancer is likely to grow and spread  Recurrence risk: How likely your cancer is to return after treatment  Therapy benefit:   How well your cancer might respond to specific treatments	Looks into inherited gene mutations that are passed from one generation to the next     Can inform your doctor about:    Personal cancer genetics:   Whether your cancer is linked to a genetic mutation  Individual cancer risk:   Whether you carry a genetic mutation that increases your risk of future cancer   Family cancer risk:   Whether the risk of cancer is hereditary and could affect your family or future generations.
Can help in making decisions about:   Having active treatment:   Whether the benefit of certain treatments is likely to outweigh the potential risks  Choosing which treatment:  Selecting the most appropriate treatment option   Treatment duration: Deciding how long the treatment should last	Can help in making decisions about:   Lowering future cancer risk: Deciding on steps such as lifestyle changes, surgery, or treatments  Regular cancer screening: Deciding if you should undergo more frequent screenings  Genetic testing for relatives: Considering whether close relatives should also undergo genetic testing
Examples: In early hormone-positive breast cancer, EndoPredict is a gene expression test that can help predict:  The risk of your cancer coming back somewhere else in the body after treatment (distant recurrence) The potential benefit of chemotherapy     In localized primary prostate cancer, Prolaris is a gene expression test that can help predict:  How likely your cancer is to spread or lead to death to help choose between active surveillance or treatment options	Examples:  In patients with breast cancer, genetic testing for genes like BRCA1 and 2 can:   Assess the risk of developing other cancers    Guide personalized screening options   Inform family members about their own potential risks   The same applies to many other cancer types, like ovarian or prostate cancer.

How can a genomic test help my cancer treatment?  

Not all cancers have a genomic test available yet. Whether a genomic test is appropriate depends on your cancer subtype and where you are in your treatment journey. 

But, if there is one suitable for your cancer, it can provide valuable insights to help tailor your treatment. For instance, there are genomic tests available for early-stage breast cancer and non-metastatic prostate cancer.

Your treatment plan will be based on various factors alongside your genomic test results, including:  

• The size, stage, and subtype of your cancer
• The number of affected lymph nodes
• Your overall health
• Which treatment outcomes matter most to you

Some genomic tests already incorporate clinical factors into their results.

Once the results are in, you and your doctor will discuss them together to decide on the next best steps.

Tailored treatment plans 

Every cancer type has its own treatment options. Genomic tests, like those available for breast and prostate cancer, can tailor therapy to the tumor’s unique biology. 

For example, a breast cancer prognostic and predictive test is available to help decide if chemotherapy or hormone therapy alone is more beneficial for you, based on your risk of the cancer returning. 

Similarly, a prostate cancer test aids in deciding between active surveillance or intensified treatment. Active surveillance is a treatment approach for prostate cancer that involves closely monitoring the cancer without immediate intervention. It is often recommended for men with low-risk, slow-growing prostate cancer. Regular check-ups, digital rectal exams, and genomic tests are used to track the progression of your cancer. If the cancer shows signs of growing or becoming more aggressive, your doctor may recommend moving from active surveillance to more intensive treatments, like surgery or chemotherapy. This approach helps avoid or delay the side effects of treatments unless they become necessary.

Genomic tests looking at gene activity linked with cancer recurrence, alongside other factors, can help to inform your doctor whether more intensive treatment is appropriate. 

This could mean chemotherapy or longer treatment. On the other hand, if the test shows your cancer is less likely to return, your doctor might not need to prescribe extra treatments.

Most cancer therapies have the potential for severe side effects, so it’s important to be able to weigh up the risks and benefits. Genomic insights are one of several factors to consider.

How can our genomic tests help your cancer treatment? 

Our genomic tests provide valuable insights that help guide personalized treatment decisions by considering various prognostic factors alongside tumor genetics.

• EndoPredict Breast Cancer Prognostic Test – for assessing the risk of recurrence and chemotherapy benefit in ER+, HER2 early-stage breast cancer 

• Prolaris Prostate Cancer Prognostic Test – for assessing the aggressiveness of localized  prostate cancer to make treatment decisions 

FAQs about genomic tests in cancer

How is a genomic test done?  

A genomic test is carried out on a tumor sample collected at your original biopsy or during surgery. This means you shouldn’t need to have an extra procedure. Results are usually available within one week.

What is the difference between gene sequencing and gene expression testing?  

Gene sequencing involves reading the genetic code, which is like reading the instruction manual of your DNA. It looks at a specific sequence of DNA within a gene to find changes (mutations) that might increase the risk of developing cancer. Gene sequencing can be performed on a blood sample (germline test) or tumor tissue (somatic test).

Gene expression testing looks at the activity levels of genes (gene expression) and is performed on a tumor sample. It helps determine the aggressiveness of the cancer based on how genes function within the tumor.

What are the benefits of genomic tests that include clinical factors? 

The decision for or against intensified therapy cannot be reduced to individual groups of genes alone. It requires a complex analysis of gene activity and behavior of the tumor. 

Some genomic tests also implement clinical factors in their analysis, offering a comprehensive assessment, by considering how clinical factors interact with gene activity to affect overall risk of recurrence. 

EndoPredict combines gene activity with clinical factors (tumor size and nodes affected).  

What is genomic testing for breast cancer?

Genomic testing for breast cancer is commonly confused with BRCA1 and 2 testing. The BRCA test is a genetic test, used to predict your risk of breast cancer, among other cancers.  

A genomic test for breast cancer is carried out when you already have cancer. It can assess the risk of the cancer returning, and whether chemotherapy is likely to be beneficial.  Learn more about EndoPredict Breast Cancer Prognostic Test.  

What is genomic testing for prostate cancer

Genomic testing for prostate cancer is not as common as for breast cancer, but tests are now available in some countries. These tests help decide between active treatment (like surgery or radiotherapy) and active surveillance. Some tests also assist in deciding whether additional hormone therapy is necessary. Learn more about Prolaris Prostate Cancer Prognostic Test. 

How much does a genomic test cost?

The cost of a genomic test depends on the brand, country and whether you have private or public healthcare.

Many genomic tests are available to be reimbursed. A genomic test is ordered by the doctor, rather than the patient. 

If you’re a healthcare professional interested in using EndoPredict or Prolaris for your patients, please contact us for further information about costs and reimbursement in your region.

About us: Eurobio Scientific is a global company with a mission to improve patients’ quality of life through specialty diagnostics. Our vision is to become a leading global specialty diagnostics company by offering highly innovative solutions to healthcare professionals to serve this purpose.

With more than 370 employees worldwide, Eurobio Scientific is dedicated to providing local support through our four manufacturing centers, three research centers, and local offices in France, The Netherlands, Germany, Italy, Switzerland, the UK, and the USA.

Our expert R&D team gather years of experience in developing advanced molecular diagnostic tests in the fields of transplant, oncology, and infectious diseases.