This page contains archived content from Clinical Value of Biomarker Testing in NSCLC.
Advancing Patient Care Through Biomarker Testing in NSCLC
- Archived supportive research
A global analysis of the value of precision medicine in oncology: the case of non-small cell lung cancer
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
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.
References
- Aggarwal C, et al. Association Between Availability of Molecular Genotyping Results and Overall Survival in Patients With Advanced Nonsquamous Non-Small-Cell Lung Cancer. JCO Precis Oncol. 2023 Jul;7:e2300191. doi: 10.1200/PO.23.00191.
- Bhandari NR, et al. Biomarker testing, treatment, and outcomes in patients with advanced/metastatic non-small cell lung cancer using a real-world database. J Natl Compr Canc Netw. 2023 Sep;21(9):934-944.e1. doi: 10.60 04/jnccn.2023.7039.
- Hofmarcher T, et al. A global analysis of the value of precision medicine in oncology – The case of non-small cell lung cancer. Front Med (Lausanne). 2023 Feb 20:10:1119506. doi: 10.3389/fmed.2023.1119506.
- Schwartzberg L, et al. Improving biomarker testing in advanced non-small-cell lung cancer and metastatic colorectal cancer: experience from a large community oncology network in the USA. Future Oncol. 2023 Jun;19(20):1397-1414. doi: 10.2217/fon-2022-1216.
- Yorio J, et al. Association of timely comprehensive genomic profiling with precision oncology treatment use and patient outcomes in advanced non-small-cell lung cancer. JCO Precis Oncol. 2024 Mar;8:e2300292. doi: 10.1200/PO.23.00292.
Providing Accessible and Equitable Biomarker Testing for NSCLC
- Archived supportive research
No archived material.
References
- Kurzrock R, et al. Healthcare disparities, screening, and molecular testing in the changing landscape of non–small cell lung cancer in the United States: a review. Cancer Metastasis Rev. 2024 May 16. doi: 10.1007/s10555-024-10187-6. Online ahead of print.
- Bruno DS, et al. Disparities in Biomarker Testing and Clinical Trial Enrollment Among Patients With Lung, Breast, or Colorectal Cancers in the United States. JCO Precis Oncol. 2022 Jun:6:e2100427. doi: 10.1200/PO.21.00427.
- Vidal GA, et al. Racial and Ethnic Inequities at the Practice and Physician Levels in Timely Next-Generation Sequencing for Patients With Advanced Non–Small-Cell Lung Cancer Treated in the US Community Setting. JCO Oncol Pract. 2024 Mar;20(3):370-377. doi: 10.1200/OP.23.00253. Epub 2024 Jan 9.
Operational Improvements to Optimize Patient Care
- Archived supportive research
Clinical utility of reflex ordered testing for molecular biomarkers in lung adenocarcinoma
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
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.
References
- Anand K, et al. Clinical Utility of Reflex Ordered Testing for Molecular Biomarkers in Lung Adenocarcinoma. Clin Lung Cancer. 2020 Sep;21(5):437-442. doi: 10.1016/j.cllc.2020.05.007. Epub 2020 May 13.
- Casolino R, et al. Interpreting and integrating genomic tests results in clinical cancer care: Overview and practical guidance. CA Cancer J Clin. 2024 May-Jun;74(3):264-285. doi: 10.3322/caac.21825. Epub 2024 Jan 4.
- Gosney JR, et al. Pathologist-initiated reflex testing for biomarkers in non-small-cell lung cancer: expert consensus on the rationale and considerations for implementation. ESMO Open. 2023 Aug;8(4):101587. doi: 10.1016/j.esmoop.2023.101587. Epub 2023 Jun 23.
- Marmarelis ME, et al. Electronic Medical Record–Based Nudge Intervention to Increase Comprehensive Molecular Genotyping in Patients With Metastatic Non–Small Cell Lung Cancer: Results From a Prospective Clinical Trial. JCO Oncol Pract. 2024 Jul 3:OP2400070. doi: 10.1200/OP.24.00070. Online ahead of print.
- Vanderpoel J, et al. Total cost of testing for genomic alterations associated with next-generation sequencing versus polymerase chain reaction testing strategies among patients with metastatic non-small cell lung cancer. J Med Econ. 2022 Jan-Dec;25(1):457-468. doi: 10.1080/13696998.2022.2053403
- Waterhouse DM, et al. Closing the testing gap: Standardization of comprehensive biomarker testing for metastatic non-small-cell lung cancer in a large community oncology practice. JCO Oncol Pract. 2023 Jun;19(6):e951-e956. doi: 10.1200/OP.22.00817. Epub 2023 May 1.