Rondell P. Graham, MBBS, consultant, Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, associate professor of laboratory medicine and pathology, Mayo Clinic, discusses the role of the pathologist in biomarker testing for patients with breast and gastrointestinal (GI) cancers.

The first role of the pathologist in biomarker testing is diagnostic, both in specific tumor types as well as in general, Graham says. For example, a substantial proportion of patients with cholangiocarcinoma experience delays in diagnosis, so pathologists can play a role in combatting this challenge.

Pathologists also ensure tissue is efficiently used because patients are living longer as the result of more effective therapies, Graham explains. It is critical to select appropriate specimens for testing rare biomarkers. Additionally, general pathologists work with molecular pathologists in developing valid biomarker tests that have appropriate sensitivity and specificity for the targets of interest, Graham concludes. 

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Rondell P. Graham, MBBS, discusses the role of the pathologist in biomarker testing for patients with breast and gastrointestinal cancers.  



Dr. Graham on the Role of the Pathologist in Biomarker Testing in Breast and GI Cancers 

Rondell Graham, MBBS, an associate professor of Laboratory Medicine and Pathology at Mayo Clinic, discusses utilizing biomarkers to guide treatment for patients with intrahepatic cholangiocarcinoma.

Currently, tests are utilized to determine which patients may respond to treatment with novel inhibitors, according to Graham. For example, detecting 

 fusions, which are present in approximately 20% of patients with intrahepatic cholangiocarcinoma, could indicate who might experience improved responses to those targeted therapies, Graham explains. Multiple studies have demonstrated the utility of testing for these biomarkers, and many drugs that target this mutation have gained regulatory approval, Graham notes. 

 mutations are also detected in this patient population, Graham says. As such, patients with these mutations could be susceptible to treatment with IDH inhibitors, Graham adds. Data suggest that these therapies have led to disease stabilization, which is clinically meaningful because historically, poor rates of response to conventional chemotherapy have been observed in this patient population, Graham concludes.

Rondell Graham, MBBS, discusses utilizing biomarkers to guide treatment for patients with intrahepatic cholangiocarcinoma.


Rondell Graham, MBBS

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Dr. Graham on the Role of the Pathologist in Biomarker Testing in Breast and GI Cancers

Dr. Graham on Utilizing Biomarkers to Guide Treatment in Intrahepatic Cholangiocarcinoma