Most patients with untreated metastatic non-small cell lung cancer (NSCLC) receive at least 1 biomarker test before starting first-line therapy, but less than half of these patients receive comprehensive molecular testing, a real-world study suggests.

The results were presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting by Makenzi Evangelist, MD, of New York Oncology Hematology in Albany, New York.

The MYLUNG study was designed to assess real-world biomarker testing patterns within the US Oncology Network, which includes more than 1000 providers across the country.


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This retrospective chart review included patients with metastatic NSCLC initiating first-line systemic therapy from April 1, 2018, to March 31, 2020. Electronic health records were used to examine whether patients received biomarker testing as well as the timing of biomarker testing.

Researchers assessed testing rates for ALK, BRAF, EGFR, ROS1, and PD-L1 biomarkers, the use of full next-generation sequencing (NGS), the time from metastatic NSCLC diagnosis to first-line therapy, and the turnaround time from biomarker testing orders to receipt of results.

The study included 3474 patients, 2820 of whom had nonsquamous disease. The patients’ median age was 69 years, 51.1% were women, 65.3% were White, and 56.7% had a performance status of 0-1.

Overall, 90% of patients had at least 1 biomarker test, and 46% had all 5 biomarker tests. The proportion of patients who received test results was 70% for EGFR, 70% for ALK, 68% for ROS1, 55% for BRAF, and 83% for PD-L1.

In all, 79% of patients received 1 or more biomarker tests before first-line therapy, 10% received a result after first-line therapy, and 11% did not undergo biomarker testing.

NGS rates increased from 33% to 45% over the period studied (2018-2020). Changes in testing rates were 54% to 62% for BRAF, 77% to 75% for EGFR, 77% to 74% for ALK, 74% to 71% for ROS1, 81% to 85% for PD-L1, and 44% to 52% for all 5 biomarkers.

The median time from metastatic NSCLC diagnosis to first-line therapy was 35 days for all patients and 36 days for tested patients. The median turnaround time from biomarker testing orders to results ranged from 10 days to 15 days for the individual biomarkers.

“[O]ur real-world study showed that most patients with metastatic non-small cell lung cancer had at least 1 biomarker test result prior to initiation of first-line therapy,” Dr Evangelist said. “However, only approximately 50% of patients had all 5 tests available prior to first-line therapy.”

Data from this phase of the study will be compared with the next phase of the MYLUNG study, which will evaluate contemporary ordering practices and turnaround times prospectively, Dr Evangelist said.

Disclosures: This research was supported by Amgen, Mirati Therapeutics, and Eli Lilly and Company. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Robert NJ, Nwokeji ED, Espirito JL, et al. Biomarker tissue journey among patients (pts) with untreated metastatic non-small cell lung cancer (metastatic NSCLC) in the U.S. Oncology Network community practices. J Clin Oncol. 2021;39:(suppl 15; abstr 9004). doi:10.1200/JCO.2021.39.15_suppl.9004

This article originally appeared on Cancer Therapy Advisor