Highlights
- •This real-world study evaluated biomarker testing and targeted therapy in mNSCLC.
- •At least 1 biomarker test was received by 89.4% of patients with mNSCLC.
- •Targeted therapy was used in 62.4% of patients with a positive biomarker test.
- •Increases in biomarker testing were observed after national guideline updates.
- •Despite recent improvements, there remain gaps in biomarker testing and treatment.
Abstract
Introduction/Background
This study was designed to describe real-world changes in biomarker testing among
patients with non-squamous, metastatic non-small cell lung cancer (mNSCLC) in a community
oncology setting from 2015 to 2020.
Patients and Methods
This retrospective study randomly selected 500 adult patients diagnosed with nonsquamous
mNSCLC to undergo chart review and data extraction. Data were extracted and validated
by 2 independent abstractors. Biomarker testing rates were described before and after
national guideline updates and FDA approval of targeted agents.
Results
At least 1 biomarker test was received by 89.4% of patients with mNSCLC. Of all patients,
46.6%, 34.6%, and 8.2% received both single-gene and next generation sequencing (NGS)-based
testing, single-gene testing only, and NGS-based testing only, respectively. However,
there were changes in testing rates at the time of drug approvals for targeted agents.
Biomarker testing increased for ALK (45.0% before 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 (increased from 29.6% before approval to 74.2% after). Biomarker
testing increased after changes were made to national guidelines for BRAF (from 18.8%
before to 68.1% after inclusion in guidelines), NTRK (from 37.2% to 56.5%), and ROS1
(increased from 40.8% to 74.5% after guideline updates). Targeted therapy was received
by 62.4% of patients with a positive biomarker.
Conclusion
Increases in biomarker testing rates were observed relative to targeted agent approvals
and national guideline updates. However, many patients with non-squamous mNSCLC did
not receive full genotyping in accordance with national guidelines and represent an
opportunity to identify reasons and solutions for barriers to care.
Keywords
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Article info
Publication history
Published online: March 18, 2023
Accepted:
March 2,
2023
Received in revised form:
February 28,
2023
Received:
October 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc.
