Seven years after her brain cancer diagnosis,
Liz Salmi decided she wanted to know more about
the makeup of the tumor that changed her life.
Salmi had already undergone two surger-ies to remove the grade II astrocytoma, an
invasive but usually slow-growing brain
tumor. After her second surgery, she was
treated with Temodar (temozolomide),
a chemotherapy drug, for two years. But
Salmi, who was 29 when she was diagnosed in 2008, knew her cancer could not
be cured. She wanted to be ready when it
returned. “I’m living with a brain cancer,
and I keep up with what’s going on,” says
the 38-year-old communications specialist, who lives in Sacramento, California.
In 2015, Salmi read about powerful
genomic sequencing tools that made
it possible to analyze tumor tissue—
peeking inside brain cancer cells and
looking for the genetic drivers of the
disease. Many experts were arguing that
tumors should be classified not only by
their appearance under a microscope—
the traditional approach—but also
according to the presence of certain
When Salmi first learned she had
brain cancer after a series of debilitating
seizures in the summer of 2008, this kind
of molecular information wasn’t widely
available to patients. “I almost feel like
I was diagnosed in the Stone Age,” she
says. But when the technology became
more widespread, she wanted to know
what molecular analysis could reveal
about her tumor. She approached her
neuro-oncologist, who cautioned her to
think about her request for a few months.
“Once you know something, you can’t
unknow it,” Salmi says, explaining her
doctor’s concern. The results of tumor
sequencing, for example, might suggest
a favorable or an unfavorable prognosis.
Or they could provide no meaningful
information at all. Still, Salmi was curious.
“The best way for me to cope was to know
everything possible,” she says.
Understanding the molecular changes
that drive brain cancer remains “poten-
tially transformative,” says Paul Mischel,