Biomarker testing and tissue journey among patients with metastatic non-small cell lung cancer receiving first-line therapy in The US Oncology Network

Robert, Nicholas J.; Espirito, Janet L.; Chen, Liwei; Nwokeji, Esmond; Karhade, Mandar; Evangelist, M.; Spira, Alexander I.; Neubauer, Marcus A.; Bullock, S.; Walberg, Jennifer; Cheng, Steven K; Coleman, Robert L.

doi:10.1016/j.lungcan.2022.03.004

Cited by 43 publications

(38 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…study could be due to the use of different databases or observational periods or both. Real‐world studies with more recent observational periods and different databases than our study have reported higher biomarker testing rates: approximately 90% of patients with at least one biomarker result available 12,13 . In our study, patients diagnosed after 2015 were more likely to be tested than those in 2012.…”

Section: Discussionmentioning

confidence: 49%

“…Real-world studies with more recent observational periods and different databases than our study have reported higher biomarker testing rates: approximately 90% of patients with at least one biomarker result available. 12,13 In our study, patients diagnosed after 2015 were more likely to be tested than those in 2012. As many of the biomarker-targeted treatments were approved after 2016, 14 changes in the diagnosis and management of aNSCLC during the observational period of our study could explain the lower rates of testing we found compared with the aforementioned studies.…”

Section: Nccn-recommended Treatment Optionsmentioning

confidence: 61%

See 1 more Smart Citation

Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States

Yang,

MacEwan,

Boppudi

et al. 2023

Cancer Medicine

View full text Add to dashboard Cite

IntroductionCharacteristics of patients in clinical trials may differ from those of real‐world patients. Our objective was to describe biomarker testing and outcomes among patients with advanced non‐small cell lung cancer (aNSCLC) in a real‐world setting.MethodsThis retrospective cohort study included patients ≥18 years old, diagnosed with stage IIIB/C or IV NSCLC, and in the TEMPUS oncology dataset from January 1, 2012, to December 31, 2020. Patient characteristics associated with biomarker testing were evaluated in patients with positive biomarkers using univariate logistic regression models. Cox proportional hazard models were used to estimate median survival.ResultsOf 9540 patients included, 41.7% had biomarker testing, and 2158 had a positive biomarker result. Men (vs women; odds ratio [OR], 0.82; 95% CI: 0.74–0.91), Black patients (vs White; OR, 0.83; 95% CI: 0.72–0.97), patients with squamous (OR, 0.22; 95% CI: 0.19–0.25) or unknown histology (OR, 0.53; 95% CI: 0.45–0.61) (vs non‐squamous histology), and patients with an Eastern Cooperative Oncology Group performance status (ECOG PS) of 2+ (OR, 0.69; 95% CI: 0.57–0.84) or missing (OR, 0.56; 95% CI: 0.48–0.66) (vs ECOG PS of 0) were less likely to undergo biomarker testing. Patients with positive biomarkers who received NCCN‐recommended treatment options (55.7%) had significantly longer median overall survival (OS) (hazard ratio [HR], 0.84; 95% CI: 0.75–0.95) and real‐world progression‐free survival (rwPFS) (HR, 0.68; 95% CI: 0.62–0.75).ConclusionMore than 50% of patients were untested for biomarkers. Patients who were less likely to be tested included men, Black patients, current smokers, patients with squamous aNSCLC, and patients with an ECOG PS of 2+. Patients with positive biomarkers who received NCCN‐recommended treatment options had significantly longer OS and PFS.

show abstract

Section: Discussionmentioning

confidence: 49%

Section: Nccn-recommended Treatment Optionsmentioning

confidence: 61%

Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States

Yang,

MacEwan,

Boppudi

et al. 2023

Cancer Medicine

View full text Add to dashboard Cite

show abstract

“…3–6 As such a significant proportion of lung cancer patients do not have test results available at the time of oncology consultation. 7–9…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6] As such a significant proportion of lung cancer patients do not have test results available at the time of oncology consultation. [7][8][9] The wait time for starting treatment is a period of uncertainty for patients that causes fear and anxiety. 10 Prolonged wait times may have a detrimental impact on patient outcomes, with fewer patients able to access effective therapy contributing to reduced survival and quality of life.…”

mentioning

confidence: 99%

Plasma-first: accelerating lung cancer diagnosis and molecular profiling through liquid biopsy

et al. 2022

View full text Add to dashboard Cite

Introduction: Molecular profiling of tumor tissue is the gold standard for treatment decision-making in advanced non-small cell lung cancer (NSCLC). Results may be delayed or unavailable due to insufficient tissue, prolonged wait times for biopsy, pathology assessment and testing. We piloted the use of plasma testing in the initial diagnostic workup for patients with suspected advanced lung cancer. Methods: Patients with ⩽15 pack-year smoking history and suspected advanced lung cancer referred to the lung cancer rapid diagnostic program underwent plasma circulating-tumor DNA testing using a DNA-based mutation panel. Tissue testing was performed per standard of care, including comprehensive next-generation sequencing (NGS). The primary endpoint was time from diagnostic program referral to cancer treatment in stage IV NSCLC patients (Cohort A) compared to a contemporary cohort not enrolled in the study (Cohort B) and an historical pre-COVID cohort referred to the program between 2018 and 2019 (Cohort C). Results: From January to June 2021, 20 patients were enrolled in Cohort A; median age was 70.5 years (range 33–87), 70% were female, 55% Caucasian, 85% never smokers, and 75% were diagnosed with NSCLC. Seven had actionable alterations detected in plasma or tissue (4/7 concordant). Fusions, not tested in plasma, were identified by immunohistochemistry for three patients. Mean result turnaround time was 17.8 days for plasma NGS and 23.6 days for tissue ( p = 0.10). Mean time from referral to treatment initiation was significantly shorter in cohort A at 32.6 days (SD 13.1) versus 62.2 days (SD 31.2) in cohort B and 61.5 days (SD 29.1) in cohort C, both p < 0.0001. Conclusion: Liquid biopsy in the initial diagnostic workup of patients with suspected advanced NSCLC can lead to faster molecular results and shorten time to treatment even with smaller DNA panels. An expansion study using comprehensive NGS plasma testing with faster turnaround time is ongoing (NCT04862924).

show abstract

“… 1 Nevertheless, fewer than half of patients have their tumors tested for the four most often altered genes ( EGFR , ALK , ROS1 , and BRAF ) in LUAD. 7 Numbers are even smaller when analyzing tumors sequenced before any systemic therapy. 7 …”

Section: Introductionmentioning

confidence: 99%

Assessing Oncologists’ Attitudes Concerning Comprehensive Genomic Profiling in Stage IV Lung Adenocarcinoma in Brazil

Fares¹,

Martinez²,

Farina³

et al. 2022

JTO Clinical and Research Reports

View full text Add to dashboard Cite

Biomarker testing and tissue journey among patients with metastatic non-small cell lung cancer receiving first-line therapy in The US Oncology Network

Cited by 43 publications

References 28 publications

Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States

Diagnosis, testing, treatment, and outcomes among patients with advanced non‐small cell lung cancer in the United States

Plasma-first: accelerating lung cancer diagnosis and molecular profiling through liquid biopsy

Assessing Oncologists’ Attitudes Concerning Comprehensive Genomic Profiling in Stage IV Lung Adenocarcinoma in Brazil

Contact Info

Product

Resources

About