Do you repeat somatic tumor testing for ovarian cancer patients after recurrence?

Times are changing and payers will have to fall in line, eventually. At this time, we already know that clonal evolution exists but is poorly understood regarding the timeline. However, if we are going to leverage "precision medicine", then to be precise one has to account for clonal evolution in determining the next best therapy. Others may argue that it is the heterogeneity between lesions that is one of the weak links in using targeted therapies, just like it is a problem with chemo. Based on that notion, perhaps clonal evolution is not as important. However, for that, we should keep in mind that ctDNA is a nice adjunct in that the more pronounced clones in terms of total tumor burden may be better reflected by liquid biopsy than by tiss...

If I have somatic tumor molecular profiling done once, I typically do not repeat. Ideally, it would be nice to repeat to see if there is any change, but practically speaking, I have trouble getting a tumor biopsy paid for if only done for profiling purposes. Also, sometimes there is insurance resistance to paying for profiling twice. I'd be interested to hear the experiences of others.