Real-world insights on biomarker testing patterns and implications for mNSCLC therapy selection

Area of Science:

• Oncology
• Molecular Diagnostics
• Health Services Research

Background:

• Biomarker testing is crucial for tailoring first-line treatments in metastatic non-small cell lung cancer (mNSCLC).
• Real-world biomarker testing patterns in mNSCLC are inconsistent and may lead to outcome disparities.

Purpose of the Study:

• To investigate real-world biomarker testing patterns in newly diagnosed mNSCLC patients.
• To analyze associations between testing, first-line treatment selection, and sociodemographic factors.

Main Methods:

• Retrospective analysis of 5611 mNSCLC patients diagnosed between January 2019 and July 2022.
• Categorization of patients based on biomarker testing: none, IHC only, <5 genes plus IHC, or ≥5 genes plus IHC.
• Multivariable analyses to assess associations between testing, treatment, and social determinants of health.

Main Results:

• Over 60% of patients did not receive guideline-concordant biomarker testing.
• Comprehensive testing correlated with increased use of targeted therapy/immunotherapy and decreased chemotherapy use.
• Testing and treatment patterns varied significantly by socioeconomic status, race/ethnicity, insurance, and region.

Conclusions:

• The majority of mNSCLC patients lack comprehensive biomarker testing, limiting precision therapy opportunities.
• Significant disparities in testing and treatment highlight the need for improved access to molecular diagnostics and payer support.
• Aligning testing and treatment with national guidelines is essential for equitable cancer care and improved patient outcomes.