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Updated: Jun 12, 2025

Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
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Next-Generation Sequencing-Based Testing Among Patients With Advanced or Metastatic Nonsquamous Non-Small Cell Lung

Alan James Michael Brnabic1, Ilya Lipkovich2, Zbigniew Kadziola2

  • 1Eli Lilly and Company, Sydney, Australia.

JMIR Cancer
|June 11, 2025
PubMed
Summary
This summary is machine-generated.

Machine learning identified factors predicting next-generation sequencing (NGS) testing in advanced non-small cell lung cancer (NSCLC). Equitable access to NGS testing is crucial for all patients, regardless of demographics or insurance status.

Keywords:
NGS testingartificial intelligencebiomarkerslung cancermachine learningnext-generation sequencingoncologypredictive modelingreal-world datatreatment guidelinestumor biomarker

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Area of Science:

  • Oncology
  • Genomics
  • Machine Learning

Background:

  • Next-generation sequencing (NGS) is essential for advanced lung cancer treatment.
  • Current guidelines recommend NGS for advanced or metastatic non-small cell lung cancer (NSCLC).

Purpose of the Study:

  • To identify demographic and clinical predictors of NGS testing in advanced NSCLC patients.
  • To determine factors influencing the likelihood and timing (early vs. late) of NGS testing.

Main Methods:

  • Utilized machine learning (logistic regression, LASSO, XGBoost) on real-world NSCLC patient data.
  • Analyzed predictors for ever vs. never and early vs. late NGS testing.
  • Evaluated model performance using area under the receiver operating curve.

Main Results:

  • Identified predictors for NGS testing, including diagnosis year, smoking history, and PD-L1 testing.
  • Factors like older age, lower performance status, Black race, and public insurance were associated with less NGS testing.
  • 84% of patients who received NGS testing did so early.

Conclusions:

  • Machine learning models consistently identified predictors for NGS testing in advanced NSCLC.
  • Ensuring equitable access to NGS testing is vital, addressing disparities related to age, race, insurance, and geography.