Abstract 401P
Background
Molecular characterization to identify biomarkers of interest has become essential for lung cancer management. However, no data are currently available in France to indicate which biomarkers are being searched, or whether NGS (Next-Generation Sequencing) panels are routinely performed. In the present study, we sought to describe, at the national scale, the use of molecular testing in routine oncology practice in order to analyze possible inequalities of access, due to potential organizational or financial barriers.
Methods
We conducted an electronic cross-sectional survey among French thoracic oncologists from Dec 2022 to Mar 2023 (funded by the French National Cancer Institute (INCa). The survey included 34 questions addressing the use (prescription, techniques…) and barriers of access (organizational, financial…). The survey was distributed to the members of two National Cooperative groups (IFCT and GFPC).
Results
A total of 123 of responses were analyzed. Validated biomarkers, such as EGFR, ALK, ROS1 and PD-L1, are routinely tested (97%, 97%, 94% and 98% of cases respectively), even if the techniques (single vs multiple genes panels) used in routine differ across respondents. More recent biomarkers are less systematically sought, with a median proportion of lung cancer patients benefiting from an extended molecular portrait amounting to 20% (with significant of this proportion variations across the type of hospitals (e.g. Comprehensive Cancer Centers: 55% vs. General Hospitals: 15%). Main barriers are organizational constraints linked to the test (delay in delivering results: 52%; lack of guidelines: 36%; complexity of the prescription circuit: 31%) or difficulties in accessing treatment (46%). The median proportion of patients benefiting from at least one liquid biopsy remains low (30%), and the use of the French Genomic Plan 2025 is still very limited (67% of respondents have never sent a sample to the 2 centralized national platforms).
Conclusions
Despite almost systematic access to validated biomarker research, disparities in the access of extensive molecular portraits exist, particularly depending on the type of healthcare facility, suggesting a need for actions to ensure equitable access for patients.
Legal entity responsible for the study
A. Bayle.
Funding
Institut National du Cancer (Ref: INCa 15911).
Disclosure
A. Bayle: Financial Interests, Personal, Advisory Board, ASCO 2022 & ESMO 2023: Sanofi; Financial Interests, Personal, Invited Speaker, Health Economics conference: Roche; Financial Interests, Personal, Invited Speaker, HTAi 2024: Bayer; Financial Interests, Personal, Other, Expert at the Commission for the Evaluation of Diagnostic, Prognostic and Predictive Health Technologies: HAS (French National Authority for Health); Financial Interests, Personal, Ownership Interest, Co founder of Klineo that is a digital platform designed to facilitate the search for suitable clinical trials, for both patients and physicians.: Klineo; Other, Personal, Other, Transportation and accommodation support for the ASCO 2023 Congress: Pfizer. D. Debieuvre: Financial Interests, Personal, Advisory Board: AstraZeneca, BMS, MSD, Janssen, Sanofi Winthrop, Amgen, Roche; Financial Interests, Personal, Invited Speaker: Takeda, Pfizer; Financial Interests, Institutional, Funding: Roche, AstraZeneca, Janssen, MSD, Pfizer, BMS, Lilly, Boehringer Ingelheim, GSK, Chugai, Chiesi, Takeda, Bayer, Sanofi Winthrop, Amgen, AbbVie. C. Chouaid: Financial Interests, Personal, Advisory Board: AstraZeneca, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen; Financial Interests, Institutional, Funding: AstraZeneca, BI, GSK, Roche, Sanofi Aventis, BMS, MSD, Lilly, Novartis, Pfizer, Takeda, Bayer, Janssen and Amgen. B. Besse: Financial Interests, Institutional, Advisory Board: AbbVie, Biontech SE, Beijing Aviston Biotechnology, Bristol Myer Squibb, CureVac AG, PharmaMar, Sanofi aventis, Regeneron; Financial Interests, Institutional, Expert Testimony: AbbVie, Bristol Myer Squibb, Eli Lilly, Ellipse pharma Ltd, CureVac AG, F.Hoffmann-La Roche Ltd, Foghorn Therapeutics Inc., Genmab, Immunocore, Owkin, Sanofi; Financial Interests, Institutional, Invited Speaker: AbbVie, AstraZeneca, Bristol Myer Squibb, MSD, Daiichi Sankyo, Eli Lilly, Ose Immunotherapeutics, Sanofi, Servier, OSE Immunotherapeutics, Sanofi, Takeda, Genmab, Taiho, AstraZeneca, Amgen, BeiGene, CureVac, Janssen, MSD, PharmaMar, Eli Lilly, Daiichi Sankyo, Enliven, Nuvalent, Ellipsis, Prelude Therapeutics; Non-Financial Interests, Personal, Leadership Role, Chair of the Scientific Chairs Council: EORTC; Non-Financial Interests, Personal, Advisory Role, Member of the Scientific Board: IFCT. J. Bonastre: Financial Interests, Personal, Advisory Board, Scientific board: BMS, MSD, Janssen, Roche; Financial Interests, Institutional, Funding, Funding of the MICADO study: BMS. All other authors have declared no conflicts of interest.