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Generation of Comprehensive Thoracic Oncology Database - Tool for Translational Research
Published on: January 22, 2011
Implementing a Precision Medicine Thoracic Service Using In-House Reflex Testing in a Large Academic-Community
Debora S Bruno1, Matthew M Mirsky2, Andrea L Donner3
1Department of Medical Oncology, City of Hope Cancer Center, Atlanta, GA.
A precision medicine service for stage IV non-small cell lung cancer (NSCLC) significantly increased next-generation sequencing (NGS) rates and identified more actionable genomic alterations (AGAs). This initiative improved turnaround times and increased targeted therapy use, suggesting superior patient outcomes.
Area of Science:
- Oncology
- Genomics
- Translational Medicine
Background:
- Broad genomic testing is crucial for treating stage IV non-small cell lung cancer (NSCLC).
- Current standard care often involves delayed or incomplete molecular profiling.
Purpose of the Study:
- To evaluate the impact of a comprehensive precision medicine service on NSCLC treatment.
- To assess improvements in next-generation sequencing (NGS) rates, turnaround times (TAT), and actionable genomic alteration (AGA) identification.
Main Methods:
- Implementation of the PREDICT (PREcision meDICine Thoracic) service: system-wide reflex NGS and PD-L1 testing, nurse navigator, molecular tumor board (MTB), and an integrated information portal.
- Comparison of prospective data post-PREDICT implementation with retrospective data.
- Decision analytic modeling to compare PREDICT with standard care and different testing strategies.
Main Results:
- NGS testing rates increased significantly (91.3% vs 60.8%) after PREDICT implementation.
- Turnaround times for NGS and PD-L1 testing were significantly reduced.
- Identification of AGAs increased (29.3% vs 22%), leading to higher targeted therapy utilization (10.6% vs 6.8%).
Conclusions:
- A precision medicine service integrating reflex testing, navigation, MTB, and informatics improves NGS uptake and efficiency in stage IV NSCLC.
- This model enhances the identification of actionable mutations, facilitating targeted therapy and potentially improving patient survival.
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