Given the importance of molecular testing and target therapy for the treatment of metastatic NSCLC, it is essential to understand how testing has been performed in clinical practice and its impact on patient care. Check out the data presented at ASCO 2021
During ASCO World Congress 2021, data were presented from MYLUNG (Molecularly Informed Lung Cancer Treatment in a Community Cancer Network) a retrospective and observational trial based on a medical record review from the US Oncology Network (covering more than 1,000 providers in the United States). The survey evaluated real-world biomarker testing rates in patients with metastatic non-small cell lung cancer (mNSCLC) under first-line systemic therapy between April 1, 2018, and March 31, 2020.
Electronic health records from IKnowMed were used to examine the time of testing: before 1-line therapy (cohort 1), after therapy (cohort 2), or no testing (cohort 3). Testing rates for ALK, BRAF, EGFR, ROS1, and PD-L1; use of NGS (next-generation sequencing) panel; time from diagnosis of mNSCLC to 1-line therapy; time to biomarker identification; and time from mNSCLC diagnosis to test results were evaluated.
A total of 3,474 adults were identified. The mean age was 69 years. 51% were women, 74% had adenocarcinoma and 76% had ECOG 0 or 1. Overall, 90% of patients had at least one test for a given biomarker, while 46% were tested for all five.
Changes in test rates from 2018 to 2020 were from 51% to 59% for BRAF,71% to 71% for EGFR,71% to 70% for ALK,69% to 67% for ROS1,82% to 84% for PD-L1, and 42% to 49% for patients tested for all five biomarkers. NGS, for example, increased from 33% to 44% (p < 0.0001).
The average time from diagnosis of mNSCLC until the administration of the 1st line of treatment for all patients was 35 days. The average time from testing to results ranged from 10 to 15 days for individual biomarkers; the time from the diagnosis of mNSCLC to biomarker results ranged from 14 to 21 days for each.
The authors conclude that most patients received at least one biomarker test prior to 1st line of treatment, but < 50% were evaluated for all five. NGS occurred in < 50% of patients but increased over the periods examined.