Why are oncologists not testing all NSCLC patients for biomarkers in the U.S. market?

Abstract

e21003 Background: NSCLC has the greatest number of biomarkers of any tumor type. If a patient is not biomarker tested, he or she may not receive access to targeted therapies that often offer greater efficacy through personalized therapy. The purpose of this research study is to examine the reasons certain lung cancer patients are not tested in the United States for biomarkers. Methods: This study followed market research best practices. The study was based on a survey of the BrandImpact Oncology panel conducted on patient visits during Q4 2020 at the point-of-prescribing. Results: The baseline measure of NSCLC patients that were being treated but had a biomarker status that was unknown ranges from 9% to 12% of patient visits. The biomarkers examined included ALK, ROS-1, EGFR and PD-L1. The Oncologists who treat NSCLC patients received the following question: When treating patients in your practice with NSCLC cancer what are your top 3 reasons for not conducting biomarker testing? As outlined in the table below which reflects all survey responses, the top four reasons for not conducting biomarker testing are: not enough tumor sample for testing purposes, patient has early stage of disease, patient is not healthy enough and patient cost associated with testing. Conclusions: The overall results indicate the absence of biomarker testing for lung cancer patients is mainly due to two different patient types. The early-stage patient was a key reason for not testing despite advances in early stage indications and diagnostic technology which provide increasing evidence that testing should be done earlier in the treatment journey. The late-stage patient which is seen more often in Academic institutions and who often has more aggressive cancer. The speed of receiving the biomarker test results for these more severe patients likely needs to be addressed. In the Community, setting cost of branded therapies can be an issue and in some cases biomarker testing is not readily available in all practices. It should also be noted that “not enough tumor sample for testing” was the number one reason for not conducting biomarker testing, but this issue can now be addressed through liquid NGS technology.[Table: see text]