This page contains archived content from Clinical Value of Biomarker Testing in NSCLC.
Advancing Patient Care Through Biomarker Testing in NSCLC
- Archived supportive research
Biomarker testing, treatment, and outcomes in patients with advanced / metastatic non-small cell lung cancer using a real-world database
Bhandari NR, et al. J Natl Compr Canc Netw. 2023
In this study, the authors compared overall survival rates by biomarker testing status and by receipt of guideline-recommended therapy in a large cohort of US patients with advanced or metastatic NSCLC. Despite recommendations from nationally recognized clinical guidelines, the overall rate of testing for actionable biomarkers was low. Of 21,572 patients studied, only 69% received testing for at least 1 actionable biomarker prior to or on initiation of first-line treatment, demonstrating opportunity for improvement.
Patients who received front-line biomarker testing and appropriate guideline-recommended therapy experienced significant improvements in overall survival rates compared with those who never received biomarker testing.
A global analysis of the value of precision medicine in oncology: the case of non-small cell lung cancer
Hofmarcher T, et al. Front Med (Lausanne). 2023
In this study, the authors assessed the value of biomarker testing and use of precision medicine for advanced NSCLC in multiple countries by comparing 1-year and 5-year survival model results of different testing scenarios:
- No biomarker testing (chemotherapy for all)
- Sequential testing (EGFR and ALK, followed by targeted therapy or chemotherapy)
- Next-generation sequencing (NGS) “multigene testing” (EGFR, ALK, ROS1, BRAF, NTRK, MET, RET, and PD-L1, followed by targeted or immunotherapy)
Use of upfront biomarker testing led to an increase in patient survival rates when compared to no testing, with a near doubling of the progression-free disease phase with NGS, and a decrease in the number of treatment-related adverse events.
Improving biomarker testing in advanced non-small-cell lung cancer and metastatic colorectal cancer: experience from a large community oncology network in the USA
Schwartzberg L, et al. Future Oncol. 2023
In this study, the authors compared biomarker testing practices between OneOnc community oncology network and other nationwide sites. NGS testing rates were higher in the OneOnc network, reflecting the success of educational, pathway, and operational initiatives. Additionally, patients who received NGS testing had a greater likelihood of receiving targeted treatment than patients who received non-NGS testing (eg, fluorescence in situ hybridization, immunohistochemistry, or polymerase chain reaction testing) or individual biomarker testing (testing for each biomarker one at a time).
However, opportunities remain to optimize personalized healthcare by increasing NGS uptake, shortening turnaround times, and reducing the number of patients who start treatment before receiving complete biomarker test results.
Providing Accessible and Equitable Biomarker Testing for NSCLC
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Operational Improvements to Optimize Patient Care
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Pathologist-initiated reflex testing for biomarkers in non-small-cell lung cancer: expert consensus on the rationale and considerations for implementation
Gosney JR, et al. ESMO Open. 2023
In this publication, the authors provide an expert consensus review of the importance of implementing reflex testing in NSCLC, in which the responsibility for comprehensive molecular testing for an agreed range of biomarkers lies with the pathologist versus the treating oncologist.
The study’s authors demonstrate how reflex testing has been shown to standardize and expedite the process of ordering biomarker tests to ensure more patients are tested and provide considerations for defining reflex testing protocol, engaging with institutional stakeholders, and defining roles and responsibilities within the multi-disciplinary care team.
Interpreting and integrating genomic tests results in clinical cancer care: overview and practical guidance
Casolino R, et al. CA Cancer J Clin. 2024
In this review publication, the authors provide a primer on the use of precision medicine and opportunities for enhanced treatment through next-generation sequencing (NGS) testing in oncology. They assert that a lack of understanding of the clinical utility of NGS and difficulty of results interpretation by practicing oncologists result in decreased use of precision medicine in routine cancer care.
The authors present practical guidance for interpreting genomic test results to help inform clinical decision-making and discuss potential challenges to wider implementation of precision medicine into routine care.
Clinical utility of reflex ordered testing for molecular biomarkers in lung adenocarcinoma
Anand K, et al. Clin Lung Cancer. 2020
In this small, single-institution study, researchers evaluated the impact of standardized reflex molecular testing, in which the pathologist orders a group of pre-approved biomarkers at the time of initial diagnosis, for patients with newly diagnosed NSCLC. The authors reported that average turnaround time for test results was significantly reduced by 37 days with reflex testing and resulted in a higher variant detection rate than standard molecular biomarker ordering practices over a 2-year timeframe.
The authors identified adoption of reflex ordering practices by physicians across sites and utilization of the institution laboratory for analyses versus an unaffiliated laboratory as contributors to improved turnaround time for testing results.
Closing the testing gap: standardization of comprehensive biomarker testing for metastatic non-small-cell lung cancer in a large community oncology practice
Waterhouse DM, et al. JCO Oncol Pract. 2023
In this study, the authors evaluated the feasibility and impact of implementing a guideline-concordant comprehensive biomarker testing program for all newly diagnosed patients with metastatic NSCLC within a large community practice. The implementation process included provider education, initial electronic health record consult notes, and accompanying order sets, with further adjustments made after an initial evaluation trial.
The study authors reported a 1-year increase in testing rates from 68% to 92.7% and demonstrated the feasibility of a standardized workflow for comprehensive biomarker testing within a multisite community-based practice.