Closing the Testing Gap: Standardization of Comprehensive Biomarker Testing for Metastatic Non-Small-Cell Lung Cancer...

Area of Science:

• Oncology
• Genomic Medicine
• Clinical Practice Improvement

Background:

• Non-small-cell lung cancer (NSCLC) is the leading cause of cancer death in the US, comprising 85% of lung cancer cases.
• Comprehensive biomarker testing, including genomic profiling and PD-L1 assessment, is recommended for metastatic NSCLC (mNSCLC) but remains underutilized.
• Suboptimal testing rates hinder personalized treatment strategies for NSCLC patients.

Purpose of the Study:

• To implement National Comprehensive Cancer Network (NCCN) guidelines for comprehensive biomarker testing in new mNSCLC patients within a community oncology practice.
• To improve the rates of comprehensive biomarker testing and documentation for mNSCLC.

Main Methods:

• A Plan-Do-Study-Act (PDSA) methodology was employed over two cycles.
• Cycle 1 focused on provider education and developing an electronic health record template and order set for mNSCLC initial consults.
• Cycle 2 involved enhancing cancer staging, data reporting, auditing, and reeducation to sustain improvements.

Main Results:

• Comprehensive biomarker testing rates increased from 68% to 92.7% over the 1-year intervention period.
• The mNSCLC initial consult template achieved a 71% utilization rate.
• Complete TNM staging and relevant biomarker documentation was achieved in 40% of cases.

Conclusions:

• Standardizing comprehensive biomarker testing for mNSCLC in a community oncology setting is feasible and leads to significant improvements.
• Reliable tracking metrics are crucial for maintaining and scaling these new processes.
• Plans are underway to scale this best practice across the US Oncology Network.