Biomarker Testing for Patients With Advanced/Metastatic Nonsquamous NSCLC in the United States of America, 2015 to 2021

Hess, Lisa M.; Krein, Peter M.; Haldane, Diane; Han, Yimei; Sireci, Anthony

doi:10.1016/j.jtocrr.2022.100336

Cited by 15 publications

(20 citation statements)

References 17 publications

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“…Use of multigene testing has increased in the US, from 28.3% in 2015 to 68.1% in 2020. 13 Contrastingly, in many Asian countries, such as China, Malaysia, and Thailand, multigene testing has…”

Section: Discussionmentioning

confidence: 99%

Biomarker Testing in Patients With Unresectable Advanced or Recurrent Non–Small Cell Lung Cancer

Sakamoto,

Matsubara,

Takahama

et al. 2023

JAMA Netw Open

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ImportanceBiomarker testing for driver mutations is essential for selecting appropriate non–small cell lung cancer (NSCLC) treatment but is insufficient.ObjectiveTo investigate the status of biomarker testing and drug therapy for NSCLC in Japan for identifying problems in treatment.Design, Setting, and ParticipantsThe REVEAL cohort study included retrospective data collection and prospective follow-up from 29 institutions across Japan. Of 1500 patients diagnosed with advanced or recurrent NSCLC between January 1 and March 18, 2021, 1479 were eligible. Cases recognized at the wrong clinical stage (n = 12), diagnosed outside the study period (n = 6), not treated according to eligibility criteria before recurrence (n = 2), and with deficient consent acquisition procedure (n = 1) were excluded.Main Outcomes and MeasuresThe primary end point was the biomarker testing status. Treatment-related factors were examined.ResultsAmong the 1479 patients included in the analysis, the median age was 72 (range, 30-95) years; 1013 (68.5%) were men; 1161 (78.5%) had an Eastern Cooperative Oncology Group performance status 0 or 1; 1097 (74.2%) were current or past smokers; and 947 (64.0%) had adenocarcinoma. Biomarker status was confirmed in 1273 patients (86.1%). Multigene testing was performed in 705 cases (47.7%); single-gene testing, in 847 (57.3%); and both, in 279 (18.9%). Biomarker testing was performed for EGFR in 1245 cases (84.2%); ALK, in 1165 (78.8%); ROS1, in 1077 (72.8%); BRAF, in 803 (54.3%); and MET, in 805 (54.4%). Positivity rates among 898 adenocarcinoma cases included 305 (34.0%) for EGFR, 29 (3.2%) for ALK, 19 (2.1%) for ROS1, 11 (1.2%) for BRAF, and 14 (1.6%) for MET. Positivity rates among 375 nonadenocarcinoma cases were 14 (3.7%) for EGFR, 6 (1.6%) for ALK, 1 (0.3%) for ROS1, 3 (0.8%) for BRAF, and 8 (2.1%) for MET. Poor physical status, squamous cell carcinoma, and other comorbidities were associated with hampered multigene testing. Targeted therapy was received as first-line treatment by 263 of 278 cases (94.6%) positive for EGFR, 25 of 32 (78.1%) positive for ALK, 15 of 24 (62.5%) positive for ROS1, 9 of 12 (75.0%) positive for BRAF, and 12 of 19 (63.2%) positive for MET. Median overall survival of patients with positive findings for driver gene alteration and who received targeted therapy was 24.3 (95% CI, not reported) months; with positive findings for driver gene alteration and who did not receive targeted therapy, 15.2 (95% CI, 7.7 to not reported) months; and with negative findings for driver gene alteration, 11.0 (95% CI, 10.0-12.5) months. Multigene testing for nonadenocarcinomas and adenocarcinomas accounted for 705 (47.7%) of all NSCLC cases.Conclusions and RelevanceThese findings suggest that multigene testing has not been sufficiently implemented in Japan and should be considered prospectively, even in nonadenocarcinomas, to avoid missing rare driver gene alterations.

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Section: Discussionmentioning

confidence: 99%

Biomarker Testing in Patients With Unresectable Advanced or Recurrent Non–Small Cell Lung Cancer

Sakamoto,

Matsubara,

Takahama

et al. 2023

JAMA Netw Open

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“… 20 Nonetheless, recent real-world studies point to an increase in genomic testing in the past years: observational data collected in the United States reveal an increase of patients ever tested by CGP from 28% in 2015 to 68% in 2020. 21 , 22 The reasons for the lack of widespread CGP requisition include costs, unavailability of proper tissue for testing, and a perceived lack of benefit from the treating physician. Our analysis was performed in a scenario where cost is not a current limitation for tissue testing, as the LungMapping Consortium has sponsored FoundationOne testing for metastatic LUAD since 2019 in Brazil.…”

Section: Discussionmentioning

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

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“…Indeed, the use of NGS as a primary test has dramatically increased during past years [ 86 ], though additional efforts are critical to implementing NGS widely as a principal testing method at baseline in NSCLC. This approach is not only suitable for primary tumor tissue but is routinely used in the transbronchial needle aspiration of lymph node [ 87 ], plasma [ 88 ], and pleural effusions [ 89 ] and could also be used from bronchoalveolar lavage fluid [ 90 ] and is also suitable for cerebrospinal fluid [ 91 ].…”

Section: From Multiple Companion Biomarkers To Ngs?mentioning

confidence: 99%

“…Delayed reporting often leads to the initiation of untargeted approaches with dismal outcomes [ 110 ] and should thus be avoided. Nevertheless, turn-around time for NGS has been reduced and is comparable to sequential approaches [ 86 ]. Importantly, novel technologies dramatically reduced turn-around times to ~24 h [ 111 ].…”

Section: From Multiple Companion Biomarkers To Ngs?mentioning

confidence: 99%

Molecular Profiling in Non-Squamous Non-Small Cell Lung Carcinoma: Towards a Switch to Next-Generation Sequencing Reflex Testing

Pujol

Heeke

Bontoux

et al. 2022

JPM

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Molecular diagnosis of lung cancer is a constantly evolving field thanks to major advances in precision oncology. The wide range of actionable molecular alterations in non-squamous non-small cell lung carcinoma (NS-NSCLC) and the multiplicity of mechanisms of resistance to treatment resulted in the need for repeated testing to establish an accurate molecular diagnosis, as well as to track disease evolution over time. While assessing the increasing complexity of the molecular composition of tumors at baseline, as well as over time, has become increasingly challenging, the emergence and implementation of next-generation sequencing (NGS) testing has extensively facilitated molecular profiling in NS-NSCLC. In this review, we discuss recent developments in the molecular profiling of NS-NSCLC and how NGS addresses current needs, as well as how it can be implemented to address future challenges in the management of NS-NSCLC.

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Biomarker Testing for Patients With Advanced/Metastatic Nonsquamous NSCLC in the United States of America, 2015 to 2021

Cited by 15 publications

References 17 publications

Biomarker Testing in Patients With Unresectable Advanced or Recurrent Non–Small Cell Lung Cancer

Biomarker Testing in Patients With Unresectable Advanced or Recurrent Non–Small Cell Lung Cancer

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

Molecular Profiling in Non-Squamous Non-Small Cell Lung Carcinoma: Towards a Switch to Next-Generation Sequencing Reflex Testing

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