Abstract 477P
Background
In the last decade, molecular profiling in mCRC has become integral to informed treatment decision-making; however, up-to-date data on testing frequency are lacking. We aimed to describe the utilisation and factors correlated with testing for RAS, BRAF and microsatellite instability (MSI) testing prior to 1L therapy initiation in mCRC.
Methods
Structured and unstructured data from the US nationwide electronic health record-derived de-identified Flatiron Health Database were used. Eligible pts had stage IV or recurrent mCRC and had initiated 1L systemic therapy for mCRC (1 Jan 2013–31 Dec 2020). RAS, BRAF and MSI testing, including next-generation sequencing (NGS) and non-NGS, performed between initial diagnosis and 1L therapy initiation, were considered. Test availability was determined by the observed specimen received date or biomarker test result date at or before 1L therapy initiation. The proportion of tested pts was calculated by year of 1L therapy initiation to assess temporal trends. Predictors for being tested were determined using logistic regression.
Results
Overall, 18,679 pts were included. A moderate increase in RAS testing was observed (2013: 40.6%; 2020: 55.3%). BRAF testing was low in 2013 (11.0%), increased with time and was comparable to RAS testing in 2020 (51.7%). MSI had the greatest increase in testing uptake (2013: 19.7%; 2020: 76.0%). Across all biomarkers, NGS testing utilisation increased. Factors correlated with RAS, BRAF and MSI testing (NGS and non-NGS) included younger age at diagnosis, a more recent diagnosis, non-de novo metastatic status, colon vs rectal cancer and white ethnicity. The odds for being tested decreased with higher age at diagnosis (e.g. odds ratio for MSI: 0.4 [95% CI 0.4–0.5] for pts ≥75 years old).
Conclusions
While we observed moderate increases in RAS testing, stronger uptake of BRAF and MSI testing was observed from 2013 to 2020; MSI uptake may be due to the increasing availability of approved cancer immunotherapies. Despite increasing trends, overall testing rates were relatively low vs other cancer types, e.g. biomarker testing in advanced non-small cell lung cancer has been shown to be >90% (PMID: 33358484).
Clinical trial identification
Editorial acknowledgement
Support for third-party writing assistance for this abstract, furnished by Islay Steele, PhD, of Health Interaction.
Legal entity responsible for the study
F. Hoffmann-La Roche Ltd.
Funding
F. Hoffmann-La Roche Ltd, Basel, Switzerland.
Disclosure
H.J. Lenz: Financial Interests, Personal, Advisory Board: BMS; Merck; Bayer; F. Hoffmann-La Roche Ltd; Oncocyte; Fulgent; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. J. Weberpals: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann-La Roche Ltd; Financial Interests, Personal, Stocks/Shares: F. Hoffmann-La Roche Ltd; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. C. Cremolini: Financial Interests, Personal, Advisory Board: Amgen; Servier; Bayer; F. Hoffmann-La Roche Ltd; Financial Interests, Institutional, Funding: Bayer; Merck; F. Hoffmann-La Roche Ltd; Servier; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. A. Grothey: Financial Interests, Institutional, Other, Honoraria: Bayer; Daiichi; Amgen; Regeneron; Merck/MSD; Mirati; Natera; CARIS; Guardant Health; Boston Biomedicals; Roche/Genentech; BMS; Foundation Medicine; Financial Interests, Personal, Advisory Role, Advisory/Consultancy: Bayer; Daiichi; Amgen; Regeneron; Merck/MSD; Mirati; Natera; CARIS; Guardant Health; Boston Biomedicals; Roche/Genentech; BMS; Foundation Medicine; Financial Interests, Institutional, Research Grant: Bayer; Boston Biomedicals; Natera; CARIS; Foundation Medicine; Roche/Genentech; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. B. Leutgeb: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann-La Roche Ltd; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. S. Mahrus: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann-La Roche Ltd; Financial Interests, Personal, Stocks/Shares: F. Hoffmann-La Roche Ltd; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. H. Nimeiri: Financial Interests, Personal, Full or part-time Employment: Foundation Medicine, Inc.; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. I. Reyes-Rivera: Financial Interests, Personal, Full or part-time Employment: F. Hoffmann-La Roche Ltd; Financial Interests, Personal, Stocks/Shares: Genentech, Inc.; Financial Interests, Personal, Stocks/Shares: F. Hoffmann-La Roche Ltd; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. J. Seligmann: Financial Interests, Personal, Other, Scientific consultancy role: Merck Serono; Financial Interests, Personal, Other, Scientific consultancy role: Pierre Fabre; Financial Interests, Personal, Other, Scientific consultancy role: Medicament; Financial Interests, Personal, Other, Scientific consultancy role: Servier; Financial Interests, Personal, Other, Scientific consultancy role: Roche Diagnostics; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. J. Tabernero: Financial Interests, Personal, Other, Scientific consultancy role: Array Biopharma; AstraZeneca; Avvinity; Bayer; Boehringer Ingelheim; Chugai; Daiichi Sankyo; F. Hoffmann-La Roche Ltd; Genentech Inc; HalioDx SAS; Hutchison MediPharma International;Ikena Oncology; IQVIA; Lilly; Menarini; Merck Serono; Merus; MSD; Mirati; NeoPhore; Novartis; Orion Biotechnology; Peptomyc; Pfizer; Pierre Fabre; Samsung Bioepis; Sanofi; Seattle Genetics; Servier; Taiho; Tessa Therapeutics; TheraMyc; Financial Interests, Institutional, Other, Financial support for clinical trials or contracted research: Amgen Inc; Array Biopharma Inc; AstraZeneca Pharmaceuticals LP; BeiGene; Boehringer Ingelheim; Bristol Myers Squibb; Celgene; Debiopharm International SA; F. Hoffmann-La Roche Ltd; Genentech Inc; HalioDx SAS; Hutchison MediPharma International; Janssen-Cilag SA; MedImmune; Menarini; Merck Health KGAA; Merck Sharp & Dohme; Merus NV; Mirati; Novartis Farmacéutica SA; Financial Interests, Institutional, Other, Financial support for clinical trials or contracted research: Pfizer; Pharma Mar; Sanofi-Aventis Recherche & Développement; Servier; Taiho Pharma USA Inc; Spanish Association Against Cancer Scientific Foundation; Cancer Research UK; Financial Interests, Personal, Other, Educational collaboration: Imedex; Medscape Education; MJH Life Sciences; PeerView Institute for Medical Education and Physicians Education Resource (PER); Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. S. Tejpar: Financial Interests, Institutional, Advisory Role: KU Leuven; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. T. Yoshino: Financial Interests, Institutional, Research Grant: MSD K.K.; Financial Interests, Institutional, Research Grant: Ono Pharmaceutical Co., Ltd.; Financial Interests, Institutional, Research Grant: Sanofi K.K.; Financial Interests, Institutional, Research Grant: Daiichi Sankyo Co., Ltd.; Financial Interests, Institutional, Research Grant: Sumitomo Dainippon Pharma Co., Ltd.; Financial Interests, Institutional, Research Grant: Chugai Pharmaceutical Co., Ltd.; Financial Interests, Institutional, Research Grant: PAREXEL International Inc.; Financial Interests, Institutional, Research Grant: Taiho Pharmaceutical Co., Ltd.; Financial Interests, Institutional, Research Grant: Amgen K.K.; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd. S. Stintzing: Financial Interests, Personal, Advisory Role, Remuneration for talks and advisory board role: Amgen; Bayer; Lilly; Merck KgaA; MSD; Pierre-Fabre; Sanofi; Takeda; Taiho; Financial Interests, Personal, Other, Invited speaker; remuneration for talks and advisory board role: Amgen; Bayer; Lilly; Merck KgaA; MSD; Pierre-Fabre; Sanofi; Takeda; Taiho; Non-Financial Interests, Personal, Research Grant, Third party medical writing support: F. Hoffmann-La Roche Ltd.