Molecular testing patterns in metastatic non-small cell lung cancer

Area of Science:

• Oncology
• Molecular Diagnostics
• Health Services Research

Background:

• Oncogene mutations and gene rearrangements in non-small cell lung cancer (NSCLC) are critical for identifying patients eligible for targeted therapies.
• Metastatic NSCLC (mNSCLC) requires timely molecular profiling to guide treatment decisions.

Purpose of the Study:

• To evaluate the frequency and timing of molecular testing in patients with mNSCLC before the initiation of systemic therapy.
• To assess adherence to guidelines recommending molecular testing for targeted therapy selection.

Main Methods:

• Retrospective analysis of medical claims data from a national health plan (January 1, 2010, to December 31, 2012).
• Identification of patients with mNSCLC using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes.
• Comparison of the timing of molecular testing (Current Procedural Terminology codes) with the start of chemotherapy or targeted therapy.

Main Results:

• A total of 2623 patients with presumed mNSCLC were analyzed.
• Molecular testing was documented in 60.9% of patients.
• In 88.8% of cases with documented testing and subsequent systemic therapy, testing occurred prior to treatment initiation, with a median of 38 days between testing and therapy.

Conclusions:

• Molecular testing for oncogene mutations and gene rearrangements in mNSCLC is frequently conducted before treatment initiation.
• Claims data suggest routine molecular profiling supports targeted therapy selection in mNSCLC.
• Further validation using patient medical records is recommended.