Approach to Biomarker Testing: Perspectives from Various Specialties

Sung, Mike; Ellis, Peter; Verma, Sunil; Duncan, Elizabeth D.; Leighl, Natasha B.

doi:10.3747/co.23.3019

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Second, although we attempted to include all medical oncologists, our study had a response rate of < 40%, which is comparable to other similarly conducted studies. 9.30, 33 , 34 A strength of the study is the participation of medical oncologists from various institutions, including oncology trainees and attending physicians ( Table 2 ). Because all medical oncologists affiliated with PSMO were invited, the probability of a differential response bias could have been lessened.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Biomarker Use in Cancer Treatment Among Medical Oncologists in the Philippines

Catedral

Tan

Chua

et al. 2020

JCO Global Oncology

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PURPOSE Several factors affect how medical oncologists in the Philippines use biomarkers in real-world practice. This study describes patterns of biomarker testing for the management of breast, colorectal, and lung cancers among medical oncologists in the Philippines. METHODS A cross-sectional survey was performed among practicing medical oncologists in the Philippines from November to December 2019. The questionnaire determined the ideal and practical use of biomarkers as perceived by the respondents. Responses were summarized. Associations between biomarker use across select conditions were determined. RESULTS A total of 127 respondents (38% of medical oncologists in the Philippines) participated in this study. In actual practice, 97% of the respondents requested estrogen receptor/progesterone receptor testing, and 93% requested human epidermal growth factor receptor 2 testing. For colorectal cancer, the respondents would use KRAS and mismatch repair/microsatellite instability, but 59.84% had never used BRAF. For lung cancer, 97.64% of respondents would test for epidermal growth factor receptor ( EGFR), 88.19% would test for PD-L1, 80.31% for anaplastic lymphoma kinase, 58.27% for ROS1, and 33.07% for BRAF. In actual practice, EGFR was the most frequently ordered test (67.72%), while 44.80% of medical oncologists had never used ROS1. The most common reason for testing was adherence to international guidelines (96%). The most commonly cited barrier to biomarker use was patients’ financial constraints (94.49%). Overall, the respondents’ use of biomarkers was not significantly associated with institutional affiliation, the number of patients they saw monthly, and the availability of biomarker tests in their areas of practice. CONCLUSION Medical oncologists in the Philippines would use biomarkers in treating breast, colorectal, and lung cancers if these were clinically indicated and if cost were not a factor. Financial difficulty experienced by patients was the most commonly cited barrier to biomarker use.

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Section: Discussionmentioning

confidence: 99%

Patterns of Biomarker Use in Cancer Treatment Among Medical Oncologists in the Philippines

Catedral

Tan

Chua

et al. 2020

JCO Global Oncology

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“…The goal of this study was to identify and measure delays at each time point within the lung tissue pathway to evaluate the tissue transit, biomarker completion time, and Delays have previously been reported in centres across Canada, some citing a total turnaround time of up to 6 weeks when a reference laboratory was not on-site. Different reasons have been identified including delays in specimen transportation, insufficient tissue to complete testing, organizational constraints, and volume [3,4,[12][13][14][15][16][17]. Although delays in total TAT were defined and quantified in the literature previously, it is not well understood which factors have the greatest impact on prolongation and thus which processes need the most urgent attention to achieve optimization.…”

Section: Introductionmentioning

confidence: 99%

Biomarker Turnaround Times and Impact on Treatment Decisions in Patients with Advanced Non-Small Cell Lung Carcinoma at a Large Canadian Community Hospital with an Affiliated Regional Cancer Centre

Fleming,

Hupel,

Mithoowani

et al. 2024

Current Oncology

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Background: Timely reporting of molecular biomarkers is critical in guiding optimal treatment decisions in patients with advanced non-small cell lung carcinoma (NSCLC). Any delays along the tissue or treatment pathway may be associated with suboptimal treatment/outcomes and a reduced quality of life. For many centres, biomarkers are tested off-site. Methods: A retrospective chart review of 123 patients with advanced NSCLC seen between 1 June 2021 and 30 June 2022 was conducted. With a focus on core biomarkers (PD L1, EGFR, and ALK), the outcome variables were as follows: total turnaround time (total TAT), divided into pre-laboratory, laboratory, and post-laboratory time intervals, as well as time to treatment decision (TOTD) and time to optimal systemic therapy decision (TOTSD). Results: At first consult, only 20.3% of patients had all core biomarker results available. The median total TAT was significantly longer for non-squamous (non-SCC) than squamous cell carcinoma (SCC) specimens (36.5 versus 22 days, p < 0.001). The median pre-laboratory time for the entire cohort was 5 calendar days. The median laboratory testing time was greater for non-SCC compared to the SCC specimens (23 versus 12 days, p < 0.001). The median time from consult to TOTD was 19 calendar days for the entire cohort. Conclusions: This study emphasizes the need for the expansion of regional resources to meet the clinical needs of advanced NSCLC patients treated at a regional cancer centre which uses an off-site molecular laboratory.

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The ins and outs of molecular pathology reporting

et al. 2017

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The raid evolution in molecular pathology resulting in an increasing complexity requires careful reporting. The need for standardisation is clearer than ever. While synoptic reporting was first used for reporting hereditary genetic diseases, it is becoming more frequent in pathology, especially molecular pathology reports too. The narrative approach is no longer feasible with the growing amount of essential data present on the report, although narrative components are still necessary for interpretation in molecular pathology. On the way towards standardisation of reports, guidelines can be a helpful tool. There are several guidelines that focus on reporting in the field of hereditary diseases, but it is not always feasible to extrapolate these to the reporting of somatic variants in molecular pathology. The rise of multi-gene testing causes challenges for the laboratories. In order to provide a continuous optimisation of the laboratory testing process, including reporting, external quality assessment is essential and has already proven to improve the quality of reports. In general, a clear and concise report for molecular pathology can be created by including elements deemed important by different guidelines, adapting the report to the process flows of the laboratory and integrating the report with the laboratory information management system and the patient record.

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Approach to Biomarker Testing: Perspectives from Various Specialties

Abstract: Background Despite its importance for patient outcomes, biomarker testing for lung cancer is not uniformly

Cited by 5 publications

References 21 publications

Patterns of Biomarker Use in Cancer Treatment Among Medical Oncologists in the Philippines

Patterns of Biomarker Use in Cancer Treatment Among Medical Oncologists in the Philippines

Biomarker Turnaround Times and Impact on Treatment Decisions in Patients with Advanced Non-Small Cell Lung Carcinoma at a Large Canadian Community Hospital with an Affiliated Regional Cancer Centre

The ins and outs of molecular pathology reporting

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