Abstract 1151P
Background
Biomarker testing and identification of actionable genomic alterations (AGA) in NSCLC pts has led to targeted therapy use and improved outcomes. As testing methods evolve, we sought to characterize the impact of different testing paradigms on TAT.
Methods
An ambispective review of non-squamous NSCLC pts at the Princess Margaret Cancer Centre (Toronto, Canada) is ongoing. Cohort 1 (C1; 01-11/15, 11 months) underwent reflex EGFR (EntroGen) and ALK (5A4 immunohistochemistry, IHC) single gene testing. Cohort 2 (C2; 02/17-09/20, 44 months) underwent reflex next generation sequencing (NGS; Trusight Tumor 15), ALK and ROS1 testing. Cohort 3 (C3; 10/20 – 05/21, 8 months) underwent reflex comprehensive NGS (161 genes, Oncomine OCA v3). Descriptive statistics are presented, including AGA found and TAT from biopsy, test request or initiation to result sign-out.
Results
The proportion of pts with AGA increased with larger NGS panel testing as did TAT for results. In C1, 66% (80/122) of pts had successful biomarker testing. In stage IV NSCLC pts, 45% had complete results at the time of oncology consultation (10/22), and 41% (9/22) had partial results. Data for C2 and C3 will be updated at ESMO 2022. Table: 1151P
| Cohort | C1 (EGFR, ALK IHC) | C2 (15 genes; ALK/ROS1 IHC) | C3 (161 genes) |
| Pts with successful testing | 80 | 1252 | 203 |
| Key Demographics Median age (range) Female Never smokers Adenocarcinoma | 70 years (33-97) 36 (45%) 23 (29%) 76 (95%) | 69 years (19-97) 657 (52%) 388 (32%) 1118 (89%) | 71 years (34-90) 122 (60%) 59 (31%) 1118 (89%) |
| Pts with AGA identified | 25 (31%) | 541 (43%) | 118 (58%) |
| Median overall TAT (biopsy to result sign-out) | 12 days (IQR: 8–16) | 27 days (IQR: 22-33) | 31 days (IQR: 27-38) |
| Median TAT (reflex test request to sign-out) | Pending | 20 days (IQR: 15–23) | 22 days (IQR: 20-28) |
| Median time to treatment (from biopsy; stage IV only) | 27 days (IQR: 21–58) | 38 days (IQR: 26–52) | Pending |
Conclusions
As biomarker platforms evolve, more AGA are identified although molecular TAT is lengthened. The TAT of larger comprehensive versus smaller NGS panels appears similar. The impact on patient treatment will be updated for ESMO 2022.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Princess Margaret Cancer Foundation.
Disclosure
All authors have declared no conflicts of interest.