Bringing biomarker testing within reach: CLEAR for CRC to empower patients from day one

When you hear the words “you have cancer,” your world shifts instantly. Questions overwhelm you. What happens next? Has the cancer spread? What treatment options are available? What gives me the greatest chance to beat this? 

You don’t want to wait. You want to talk to a doctor and start treatment right away. But there is a vital step before treatment begins that could help determine whether it will be effective. And for many patients, especially those newly diagnosed, these specific answers never reach them.

It’s called biomarker testing, and even though it’s one of the most important clinical tools available, it is often overlooked. 

Why Biomarker Testing Matters

When asked what biomarker testing is, Dr. Erin Siegel says, “It represents the biology of your disease, which will give you and your doctors information on how to treat it.” 

Dr. Seigel knows this better than almost anyone. As the lead researcher on CLEAR for CRC, part of the Colorectal Cancer Alliance’s larger Project Cure CRC, she is working to ensure patients not only know what biomarker testing is, but also understand why it could change their treatment course.

“Every tumor is unique,” Dr. Siegel explains. “Just as no two people are the same, cancer behaves differently from one patient to the next. Biomarker testing reads a tumor’s ‘molecular fingerprint,’ revealing information that can determine which treatments are likely to work best.” 

That’s especially important now, as new therapies are emerging that specifically target those genetic characteristics. 

“When a patient is tested right after diagnosis, they have the opportunity to start the best treatment up front or qualify for a clinical trial tailored to their tumor,” Dr. Siegel said.

The Cost of Not Knowing

If a patient begins first-line treatment without testing, they might learn later that they qualify for a clinical trial but are no longer eligible to enroll. Others may miss a chance to use a therapy uniquely suited to their tumor biology.

“Biomarker testing puts patients on the right foot,” Dr. Siegel said. “It sets them up for the best outcome possible.”

Insurance can also feel like a barrier, but the landscape is changing. Public and private payers are increasingly covered. Biomarker testing and testing companies often offer financial assistance when they don’t. The Alliance is actively advocating to expand this access nationwide.

What CLEAR for CRC Is Doing About It

In previous years, the Alliance convened focus groups to identify obstacles to biomarker testing. Patients told us they didn’t understand what biomarker testing was. Providers said communication wasn’t consistent. And disparities were glaring — people in rural and underserved communities were dramatically less likely to receive testing at all.

That conversation led to a bold idea: tackle knowledge gaps from every angle, including those of the patient, provider, and system.

CLEAR for CRC focuses on three key strategies:

• Increase awareness where it’s needed most. The Alliance is partnering with clinics serving rural and medically underserved regions and underserved populations, launching targeted outreach to help patients know what biomarker testing is before they set foot in an oncologist’s office.
• Support patients directly through trained navigators. Participants will be enrolled in a study in which trained navigators help them understand testing, navigate insurance and financial support, and ensure conversations happen early.
• Equip local providers with CRC-specific tools. Many physicians in rural areas are generalists treating multiple cancers. CLEAR for CRC will offer simple, digestible education to help them consistently recommend, order, and discuss testing.

Putting Patients at the Center

CLEAR for CRC isn’t the first effort to try improving biomarker testing, but Dr. Siegel says it’s the first to be built directly around patient voices.

“This is truly a patient-centered initiative,” she said. “Patients are at the heart of everything we’re doing. We want them to feel empowered to advocate for themselves.”

The Alliance expects to not only increase testing but also to shift what patients expect from their care. A patient who knows the right question to ask is harder to overlook.

A Future Where Testing Isn’t the Exception

When CLEAR for CRC succeeds, biomarker testing won’t be something only some patients receive, it will be a standard part of colorectal cancer care, especially among those who have historically been left out.

And most importantly? People living with this disease will be better equipped to manage it from day one.

“This project has the potential to truly change the trajectory of care,” Dr. Siegel said. “We want every patient to feel informed, supported, and ready to ask for what they deserve.”