A study aimed to analyze changes in biomarker testing among patients with metastatic non-small cell lung cancer (mNSCLC) in a community oncology setting between 2015 and 2020. The research involved 500 adults with non-squamous mNSCLC, with their medical records reviewed and data extracted. The study investigated testing rates before and after national guideline updates and FDA approval of targeted agents.
Results indicated that 89.4% of mNSCLC patients underwent at least one biomarker test. Among all patients, 46.6% received both single-gene and next-generation sequencing (NGS) testing, 34.6% received single-gene testing only, and 8.2% underwent NGS-based testing exclusively. Notably, testing rates changed with drug approvals for targeted agents. Biomarker testing increased significantly for various markers such as ALK (from 45.0% to 78.3% after ALK-targeted drug approval), BRAF (from 20.0% to 67.8%), EGFR (from 20.0% to 78.2%), NTRK (from 34.6% to 55.7%), and ROS1 (from 29.6% to 74.2%).
Additionally, changes in national guidelines prompted increased testing rates for BRAF (from 18.8% to 68.1% after guideline inclusion), NTRK (from 37.2% to 56.5%), and ROS1 (from 40.8% to 74.5%). Of those with positive biomarkers, 62.4% received targeted therapy.
In conclusion, biomarker testing rates rose in response to targeted agent approvals and guideline updates. However, a substantial number of non-squamous mNSCLC patients did not undergo comprehensive genotyping as recommended by national guidelines. This gap presents an opportunity to explore the reasons behind these disparities and develop solutions to overcome barriers in delivering optimal care.
Source: https://linkinghub.elsevier.com/retrieve/pii/S1525-7304(23)00050-5
