The following is a summary of “Real-World Biomarker Testing Patterns in Patients With Metastatic Non-Squamous Non-Small Cell Lung Cancer (NSCLC) in a US Community-Based Oncology Practice Setting,” published in the July 2023 issue of the Lung Cancer by Sireci et al.
This investigation aimed to describe changes in biomarker testing among patients with metastatic nonsquamous non-small cell lung cancer (mNSCLC) in a community oncology setting from 2015 to 2020. This retrospective study randomly selected 500 adult patients with nonsquamous mNSCLC to have their medical records reviewed and data extracted. Two abstractors extracted and validated the extracted data independently. The rates of biomarker testing before and after national guideline revisions and FDA approval of targeted agents were described.
At least one biomarker test was administered to 89.4% of mNSCLC patients. About 46.6%, 34.6%, and 8.2% of all patients, respectively, received both single-gene and next-generation sequencing (NGS)-based testing, single-gene testing only, and NGS-based testing only. However, testing rates changed during the drug approval process for targeted agents. Biomarker testing increased for ALK (from 45.0% before approval to 78.3% after), BRAF (from 20% to 67.8%), EGFR (from 20% to 78.2%), NTRK (from 34.6% to 55.7%), and ROS1 (from 29.6% before approval to 74.2% after). Biomarker testing increased after modifications were made to national guidelines for BRAF (from 18.8% before inclusion in guidelines to 68.1% after inclusion), NTRK (from 37.2% to 56.5%), and ROS1 (from 40.8% to 74.1% after guideline updates).
62.4% of patients with a positive biomarker were administered targeted therapy. Biomarker testing rates increased with targeted agent approvals and national guideline revisions. However, many patients with nonsquamous mNSCLC did not receive complete genotyping by federal guidelines, presenting an opportunity to identify barriers to care and their causes.