Tumor biopsy

[Rexwaterbury]

I am scheduled for a tumor biopsy of my right scapula next week. Unfortunately the lu177/ac225 shrunk all of my nodes to the point where biopsy of a node would be quite difficult, so bone it is. My questions include where to send it and what to send it for. The local pathology department I’m assuming will do the general pathology to determine adenocarcinoma vs NE. For the genomic testing, which lab is recommended? Caris, Foundation, or other? What testing is requested - a general panel or specific mutations? Do I have to request things such as testing for brca, ARV7, PD1, PDL1, msi, tmb, psma, etc? Or will my local oncologist know the routine? Thanks in advance.

[Tall_Allen]

Good points for discussion with your oncologist. He probably has a favorite lab to do the genomics. I haven't seen anything to indicate the one of the genomics analyses companies is preferred.

Your local pathologist will do the histology and IHC. The Wang Lab at Duke probably has more antibody stains than your local pathologist, but local may be adequate. IHC analysis can detect some of those you mentioned - PSA, PSMA, PD-L1,, and AR. If it is a protein you're looking for, IHC is what you need.