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Biomarker Testing And Me
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What tests might be useful for me?

These are some of the tests, scans and procedures commonly done in the United States. It’s important to note that this structure might not be followed in other countries.

If you are a stage I patient:

At diagnosis

  • Colonoscopy
  • Ct scan of chest, abdomen, pelvis
  • MRI of pelvis
  • CEA testing
  • Tumor biopsy testing for MSS/MSI-H and BRAF status
  • ctDNA testing through tests such as Guardant REVEAL (optional)

If you’ve had surgery

  • Tumor testing for MSS/MSI-H and BRAF status, if not done before
  • ctDNA testing through tests such as Signatera (if pre-treatment tissue samples are available)

For surveillance

  • Routine bloodwork
  • CEA testing
  • CT scan
  • Colonoscopy
  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL

If you later have an enlarged lymph node or suspected spot on an organ

  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL
  • PET or CT scan (or MRI, if the spot is on the liver)

If you are a stage II patient:

At diagnosis

  • Colonoscopy
  • CT scan of chest, abdomen, pelvis
  • MRI of pelvis
  • CEA testing
  • Tumor biopsy testing for MSS/MSI-H and BRAF status
  • ctDNA testing through tests such as Guardant REVEAL

If you’ve had surgery

  • Tumor testing for MSS/MSI-H and BRAF status, if not done before
  • Immunoscore testing of tumor tissue
  • ctDNA testing through tests such as Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL. This can help your care team decide if chemotherapy is necessary, and if so, how long the treatment should be

For surveillance

  • Routine bloodwork
  • CEA testing
  • CT scan
  • Colonoscopy
  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL

If you later have an enlarged lymph node or suspected spot on an organ

  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL
  • PET or CT scan (or MRI, if the spot is on the liver)

If you are a stage III patient:

At diagnosis

  • Colonoscopy
  • CT scan of chest, abdomen, pelvis
  • MRI of pelvis
  • CEA testing
  • Tumor biopsy testing for MSS/MSI-H and BRAF status
  • ctDNA testing through tests such as Guardant REVEAL

If you’ve had surgery

  • Tumor testing for MSS/MSI-H and BRAF status, if not done before
  • Immunoscore testing of tumor tissue
  • ctDNA testing through tests such as Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL. This can help your care team decide how long your chemotherapy regimen should be

For surveillance

  • Routine bloodwork
  • CEA testing
  • CT scan
  • Colonoscopy
  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL

If you later have an enlarged lymph node or suspected spot on an organ

  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant REVEAL
  • PET or CT scan (or MRI, if the spot is on the liver)

At progression

  • Liquid biopsies such as Guardant360, Guardant360 CDx, or Foundation One Liquid
  • Tumor genomic testing through extended genomic panels, such as Foundation One, Tempus, or Caris

If you are a stage IV patient:

  • Colonoscopy
  • Ct scan of chest, abdomen, pelvis
  • MRI of pelvis
  • CEA testing
  • Tumor biopsy testing for MSS/MSI-H and BRAF status
  • Tumor genomic testing through extended genomic panels, such as Foundation One, Tempus, or Caris
  • Liquid biopsy tests such as Foundation One Liquid
  • ctDNA testing through tests such as Guardant360

On chemotherapy

  • Routine blood tests
  • CEA testing
  • CA 19-9 if CEA is not a good biomarker for you
  • CT scan
  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available)

On regimens that include targeted therapies (herceptin, vectibix, erbitux, BRAF inhibitor, MEKi, immunotherapy)

  • Routine blood tests
  • CEA testing
  • CA 19-9 if CEA is not a good biomarker for you
  • CT scan
  • Liquid biopsies such as Guardant360, Guardant360 CDx, or Foundation One Liquid

At progression

  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant360
  • Tumor genomic testing through extended genomic panels, such as Foundation One, Tempus, or Caris

For surveillance

  • Routine blood tests
  • CEA testing
  • CA 19-9 if CEA is not a good biomarker for you
  • CT scan
  • ctDNA testing done through Signatera (if pre-treatment tissue samples are available) or Guardant360

Want to chat with other patients going through the same thing?

Join one of our COLONTOWN Facebook groups:

  • 1st Avenue (Stage I patients)
  • 2nd Avenue (Stage II patients)
  • 3rd Lane (Stage III patients)
  • Four Corners (Stage IV patients)
  • NEDS Ballroom (Patients with current or past NED — no evidence of disease — status)

Interested in joining? Fill out the registration form here.