Abstract 1162P
Background
Professional guidelines advise broad molecular profiling for at least 8 biomarkers in non-small cell lung cancer (NSCLC) that have either approved targeted therapies or available clinical trials. Up to 38% of patients with metastatic NSCLC have inadequate tumor samples for molecular analysis at diagnosis. Professional guidelines recommend that if there is insufficient tissue to allow for testing of all biomarkers, repeat biopsy and/or plasma testing should be done. While both plasma and tissue testing are currently being incorporated into the standard workup of patients with NSCLC, there is currently no standardized workflow for testing. We performed a retrospective chart review to assess real world liquid and tissue biopsy - based biomarker testing and reflex testing dynamics to understand the current NSCLC biomarker testing scenario in a large US community practice.
Methods
Advanced NSCLC patients (n=361) who were diagnosed or received first-line treatment on or after 1/1/2020 were included. Data was extracted from the electronic medical records in participating practices as well as via abstraction of patient records when available. Patient-level data was anonymized and reported in aggregate. Data collected for this analysis was evaluated in accordance with regulatory requirements for electronic records. We examined patient journeys from biopsy to treatment, determined the percentage of liquid and tissue-based testing, test failure rate, reflex testing rate, and turnaround time.
Results
43% of NSCLC patients received both liquid and tissue testing, while 41% received only tissue testing. The median TAT for tissue testing was 10 days and for liquid testing was 7 days. Reflex testing occurred in 56% of solid tumor test failures and 31% of liquid tumor tests with negative results. Patients with both a liquid and tissue test had results in hand prior to treatment more often than those who had either test alone.
Conclusions
In this real-world study, 43% of NSCLC patients received both liquid and tissue testing. Patients with both a liquid and solid tumor test had results in hand prior to treatment more often than those who just had a solid or liquid tumor test. These results demonstrate the utilization of tissue and liquid testing in a large US community practice.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Illumina.
Disclosure
All authors have declared no conflicts of interest.