Genomic biomarker testing and treatment in advanced NSCLC: Practice patterns and barriers in a global survey of oncology point-of-care mobile app users.

Authors

null

Anne Jacobson

Siyemi Learning, Manchester, United Kingdom

Anne Jacobson , Eugene Pozniak , Kevin Dan Bambury , Eoin O'Carroll , Renita George , Giuseppe Luigi Banna

Organizations

Siyemi Learning, Manchester, United Kingdom, ONCOassist, Killarney, Ireland, Department of Oncology, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
Independent medical education grants from Pfizer and Takeda Pharmaceuticals U.S.A., Inc.

Background: Appropriate molecular testing and oncogene-directed treatment planning are essential best practices for managing patients with advanced non-small cell lung cancer (aNSCLC) who are potential candidates for targeted therapy. Understanding real-world practices and challenges among oncology health care professionals (HCPs) is necessary to inform the development of digital tools and other initiatives that support optimal care. Methods: From 12/2022 to 01/2023, 142 HCPs who treat aNSCLC completed an online survey related to NSCLC genomic biomarker testing and treatment planning. Participants were recruited from a global cohort of HCPs who are active users of an oncology point-of-care mobile app following the launch of an NSCLC decision-support tool and educational intervention. Results: Participants included medical oncologists (87%), surgical oncologists (3%), pulmonologists (2%), and nurses (4%) from 62 countries. Most (72%) reported providing care for ≥5 pts/month with aNSCLC; 27.5% provide care for ≥20 pts/month. HCPs reported testing the following genomic biomarkers in 100%, 50-99%, 1-49%, and 0% of patients with aNSCLC, respectively: EGFR (44%, 23%, 27%, 4%), ALK (41%, 20%, 29%, 8%), ROS1 (32%, 19%, 23%, 22%), BRAF (23%, 20%, 23%, 31%), NTRK (12%, 14%, 22%, 47%), HER2 (11%, 17%, 27%, 42%), KRAS (23%, 15%, 25%, 33%), RET (13%, 13%, 25%, 44%), MET exon 14 (15%, 12%, 27%, 42%). Reported barriers varied in frequency (Table 1), with the most common involving biomarker test turnaround time. The majority of HCPs reported often or sometimes feeling that “results take too long,” and they (80%) and/or their patients (81%) are eager to start treatment. HCPs also commonly reported often or sometimes not being sure about which tests to order (45%), when to test (43%), which 1st-line therapy to select (45%), which 2nd- or later-line therapy to select (57%), and how to manage adverse events of oncogene-targeted therapy (50%). Conclusions: In current real-world practice, the majority of HCPs report suboptimal testing for targetable genomic alterations (EGFR, ALK, ROS1, BRAF, NTRK, HER2, KRAS, RET, and MET exon 14) in patients with aNSCLC. Identified common barriers represent opportunities for future interventions to improve biomarker-directed NSCLC care.

Frequency of barriers to NSCLC biomarker testing and treatment planning (N = 142).

BarrierOftenSometimesNever
Not sure which patients to test5%27%68%
Not sure which tests to order (eg, single- vs multi-gene panel)10%35%55%
Not sure when to test (eg, diagnosis vs progression)7%35%57%
Results take too long; I am eager to start treatment27%53%20%
Results take too long; my patients are eager to start treatment34%46%21%
Not sure which 1st-line therapy to select8%37%55%
Not sure which 2nd-line (and later) therapy to select10%47%43%
Not sure how to manage AEs related to targeted therapy7%44%50%

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e21004)

DOI

10.1200/JCO.2023.41.16_suppl.e21004

Abstract #

e21004

Abstract Disclosures