Abstract 1368P
Background
Molecular testing for biomarkers in patients (pts) with advanced/metastatic NSCLC (a/mNSCLC) is essential for diagnostic testing and use of targeted therapy. Testing patterns across lines of therapy (LOT) for pts with a/mNSCLC remain unclear.
Methods
This retrospective real-world study used ConcertAI Patient360™ database to assess biomarker testing patterns among adults with nonsquamous a/mNSCLC (2017–2022). Eligible pts received ≥1 LOT with ≥90-day follow-up. Biopsy and biomarker testing assessed actionable genetic alterations (ALK, BRAF, EGFR, KRAS, NTRK, RET, ROS1) and PD-L1 by LOT (first-, second-, third-line [1L, 2L, 3L]), test modality (IHC, FISH, CISH, NGS, PCR), and sample type (tissue/liquid).
Results
4528 pts were included; median age 67 years and from a community setting (76%). NGS rate at 1L was 57% overall (2017–2022) and increased to 80% during 2020–2022. Testing for ≥1 biomarker was 85% (1L), 31% (2L), 26% (3L) (overall, 2017–2022); and 89% (1L), 37% (2L), 28% (3L) (2020–2022). EGFR, BRAF, KRAS, RET, and ROS1 (Table) were mostly tested using NGS (56% at 1L vs 51% IHC, 21% FISH, and 10% PCR). Testing was most often conducted with tissue at 1L (64%) and liquid in 2L+ (41% each of tested 2L pts and 3L pts). At 2L, only 6% of pts had tissue re-biopsy, which dropped to 4% in 3L. Pts with 1L targeted therapy had higher re-testing (41% vs 25%, P<0.001) rates regardless of sample type in 2L than those who did not. Table: 1368P
N | Any biomarker (%) | PD-L1 (%) | ALK (%) | BRAF (%) | EGFR (%) | KRAS (%) | METexon14 (%) | NTRK (%) | RET (%) | ROS1 (%) | |
1L | 4528 | 85 | 71 | 73 | 65 | 78 | 64 | 46 | 40 | 55 | 71 |
2L | 1394 | 31 | 19 | 24 | 23 | 26 | 22 | 19 | 15 | 21 | 24 |
3L | 473 | 26 | 14 | 20 | 20 | 22 | 19 | 16 | 11 | 18 | 21 |
Conclusions
Tissue was most frequently used in 1L for biomarker testing by NGS for genetic alterations or IHC for PD-L1; however, tissue was not regularly re-biopsied in 2L+ settings. Biomarker testing rates drop as pts navigate through LOT. Re-testing rate is higher among pts with an actionable mutation in 1L. Standardization of biomarker testing post-1L is needed to facilitate optimal later-line treatment decisions and individualized care for pts with a/mNSCLC.
Clinical trial identification
Editorial acknowledgement
Medical writing support was provided by Hayley Ellis, PhD, of Fishawack Facilitate Ltd, part of Fishawack Health, funded by AbbVie.
Legal entity responsible for the study
AbbVie.
Funding
AbbVie funded this real-world study and participated in the study design, research, analysis, interpretation of data, and the review and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship.
Disclosure
C. Aggarwal: Financial Interests, Institutional, Research Funding: AstraZeneca, Genentech, Incyte, Macrogenics, Merck Sharp & Dohme, MedImmune; Financial Interests, Institutional, Funding, Consultation fees: Genentech, Lilly, Celgene Merck, AstraZeneca, Blueprint Genetics, Shionogi, Daiichi Sankyo/AstraZeneca, Regeneron/Sanofi, Eisai, BeiGene, Turning Point, Pfizer, Janssen, Boehringer Ingelheim. Q. Xu, S. Ng, R. Kamalakar, S.A. Crawford, S. Beruti, A. Myftiu: Financial Interests, Personal, Full or part-time Employment: AbbVie; Financial Interests, Personal and Institutional, Stocks/Shares: AbbVie. M.B. Beasley: Financial Interests, Institutional, Advisory Board: AbbVie, AstraZeneca, Daiichi Sankyo.
Resources from the same session
1369P - BrigAlec study: Focus on alectinib efficacy after brigatinib exposure in BrigALK2 study (GFPC 02-2019)
Presenter: Renaud Descourt
Session: Poster session 20
1370P - Efficacy and safety of ensartinib in ALK-positive non-small cell lung cancer patients with brain metastases: A multicenter, open-label, single-arm, phase II study
Presenter: Jianhua Chang
Session: Poster session 20
1371P - First-line alectinib vs. brigatinib in advanced metastatic NSCLC with ALK rearrangement: Real-world data
Presenter: Young Kyung Jeon
Session: Poster session 20
1372P - Repotrectinib in patients (pts) with NTRK fusion-positive (NTRK+) advanced solid tumors, including NSCLC: Update from the phase I/II TRIDENT-1 trial
Presenter: Ben Solomon
Session: Poster session 20
1373P - Efficacy and safety of taletrectinib in patients (Pts) with ROS1+ non-small cell lung cancer (NSCLC): Interim analysis of global TRUST-II study
Presenter: Maurice Pérol
Session: Poster session 20
1374P - Survival and therapy analysis of small-scale ROS1-mutant non-small cell lung cancer (NSCLC) patients
Presenter: Moritz Glaser
Session: Poster session 20
1375P - Beamion Lung 1, an ongoing phase Ia/Ib trial of the HER2 TKI, BI 1810631 in patients (pts) with advanced solid tumors with HER2 aberrations: Latest data
Presenter: Frans Opdam
Session: Poster session 20
1377P - Differential impact of EGFR exon 20 insertion location on tyrosine kinase inhibitor sensitivity
Presenter: Xiuning Le
Session: Poster session 20
1378P - Efficacy and safety of tunlametinib (HL-085) combined with vemurafenib in patients with advanced BRAF V600-mutated solid tumors: A multicenter, phase I study
Presenter: Yuan-Kai Shi
Session: Poster session 20
1379P - Preliminary results of phase II KUNPENG study of vebreltinib in patients (Pts) with advanced NSCLC harboring c-MET alterations
Presenter: Jin-Ji Yang
Session: Poster session 20