Next-Generation Sequencing Trends among Adult Patients with Select Advanced Tumor Types: A Real-World Evidence...

Area of Science:

• Oncology
• Genomics
• Health Services Research

Background:

• Next-generation sequencing (NGS) is crucial for identifying actionable oncogenic variants to guide molecular biomarker-based therapies.
• Limited data exist on the prevalence and trends of NGS utilization in the United States across various cancer types.
• Increasing approvals of targeted therapies necessitate understanding current NGS adoption rates.

Purpose of the Study:

• To examine the trends in NGS utilization among adult patients with select metastatic solid tumors and central nervous system tumors in the US.
• To identify factors associated with NGS use and analyze time-to-test metrics.
• To assess the current landscape of NGS adoption in the context of evolving treatment paradigms.

Main Methods:

• Retrospective analysis of US health care claims data (Optum Clinformatics Data Mart) from January 1, 2014, to June 30, 2021.
• Inclusion of 63,209 adult patients diagnosed with specific metastatic solid tumors or central nervous system tumors.
• Examination of NGS use trends over time, time to NGS from diagnosis, and predictors of testing.

Main Results:

• NGS utilization showed a modest increase from 2015 (0.0%-1.5%) to 2021 (2.1%-17.4%) across tumor types.
• NGS rates remained below 10% in the final period for breast, colorectal, head and neck, soft tissue sarcoma, thyroid, and CNS cancers.
• Median time to NGS varied by cancer type, being shortest for non-small-cell lung cancer and longest for breast cancer. Predictors of NGS varied by tumor type, with comparable rates for minorities and White patients in select cancers.

Conclusions:

• Despite improvements in payer policies and therapy approvals, NGS rates remain low across many cancer types.
• The observed increase in NGS use is modest, highlighting a gap in adoption for molecular biomarker-based treatments.
• Further interventions are necessary to enhance NGS utilization and improve patient outcomes through precision oncology.