The following is a summary of “Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer,” published in the June 2023 issue of the Clinical Lung Cancer by Osazuwa-Peters et al.

Despite recommendations for molecular testing regardless of patient characteristics, metastatic non-small cell lung cancer (mNSCLC) patients differ in their receipt of molecular testing for oncogenic drivers. It is necessary to investigate these differences and their effects on treatment to identify areas for enhancement. Researchers conducted a retrospective cohort investigation on 3,600 adult patients diagnosed with mNSCLC between 2011 and 2018 using the PCORnet’s Rapid Cycle Research Project dataset. 

Log-binomial, Cox proportional hazards (PH), and time-varying Cox regression models were used to determine the receipt of molecular testing and the time from diagnosis to molecular testing and initial systemic treatment in the context of patient age, sex, race/ethnicity, and the presence of multiple comorbidities. The majority of patients in this cohort were ≤65 years old (median [25th, 75th]: 64 [57, 71]), male (54.3%), non-Hispanic white (81.6%), and had >2 comorbidities besides mNSCLC (54.1%). 49.9% of the population underwent molecular testing. 

Patients who underwent molecular testing were 59% more likely to receive initial systemic treatment than patients who had not yet undergone testing. Multiple comorbidities were positively associated with the receipt of molecular testing (RR, 1.27; 95% CI, 1.08, 1.49). In academic institutions, molecular testing was associated with earlier initiation of systemic treatment. This finding highlights the need to enhance the rate of molecular testing among mNSCLC patients during clinically relevant periods. Further research is required to validate these findings in community centers. 

Source: sciencedirect.com/science/article/abs/pii/S1525730423000499