Pathologists to weigh challenges of new molecular tests

The related issues of healthcare costs and the appropriateness of molecular and genetic testing will be considered by pathologists attending the annual meeting this week of the College of American Pathologists.

The meeting, which opens Sept. 7 in Chicago, is expected to draw more than 1,300 pathologists.

As genetic testing becomes less expensive and new research identifies links between gene mutations and cancer, pathologists face growing questions about when genetic and molecular testing should be used and how patients should be counseled and informed. “Not all information may be appropriate for a patient,” said Dr. Gene Herbek, president of the College of Pathologists and a pathologist at the Nebraska Methodist Health System.

This may be challenging to explain to patients as laboratories develop and promote new genetic tests. Making the issue more complicated are cost concerns. While prices for molecular testing have dropped significantly in recent years, some tests still cost thousands of dollars.

Herbek said an example of an appropriately used test is with the oncology drug Herceptin, which works only when treating women with HER2- positive breast cancer. The drug can be highly toxic to the heart and lungs and costs upwards of $100,000. “It's a good therapy if you have the molecular marker,” he said. “We can afford it when it's done for the right reasons.”

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