Knowledge and Practice Patterns Among Pulmonologists for Molecular Biomarker Testing in Advanced Non-small Cell Lung Cancer

Jett, James R.; Roy, Upal; Johnson, Bruce E.; King, Jennifer C.; Martin, Nikki A.; Osarogiagbon, Raymond U.; Rivera, M. Patricia; Rosenthal, Lauren; Smith, Robert A.; Silvestri, Gerard A.

doi:10.1016/j.chest.2021.06.027

Cited by 18 publications

(22 citation statements)

References 40 publications

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“…9 These examples confirm the importance of CBT in appropriate patients before the initiation of therapy. 10 Currently, there are different approaches to testing for genetic alterations that can potentially guide treatment. Multiple single-gene assays, each of which identifies a single analyte, are needed to select the appropriate targeted agent or immunotherapy; however, if this is done in sequence, it can result in significant delays in initiating either novel or conventional therapies according to the testing outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…However, significant variability in CBT rates exists with respect to practice type, setting, and the presence of institutional policy as well as health care provider subspecialization 10,13 . Furthermore, there is significant variation in the coordination of CBT between subspecialty services across institutions 10 …”

Section: Introductionmentioning

confidence: 99%

“…12 However, significant variability in CBT rates exists with respect to practice type, setting, and the presence of institutional policy as well as health care provider subspecialization. 10,13 Furthermore, there is significant variation in the coordination of CBT between subspecialty services across institutions. 10 Despite evidence demonstrating the effectiveness of CBT and targeted therapies or immunotherapy, the incorporation of biomarkers into clinical practice is lagging behind recommendations in clinical guidelines.…”

Section: Introductionmentioning

confidence: 99%

“…There is increased clinical interest in incorporating NGS into clinical practice, with 75% of oncologists nationally reporting the use of NGS testing in 2017 and with 27% reporting incorporating NGS results into their treatment decisions 12 . However, significant variability in CBT rates exists with respect to practice type, setting, and the presence of institutional policy as well as health care provider subspecialization 10,13 . Furthermore, there is significant variation in the coordination of CBT between subspecialty services across institutions 10 …”

Section: Introductionmentioning

confidence: 99%

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State legislative trends related to biomarker testing

Sadigh

Goeckner

Kazerooni

et al. 2022

Cancer

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Comprehensive biomarker testing has become the standard of care for informing the choice of the most appropriate targeted therapy for many patients with advanced cancer. Despite evidence demonstrating the need for comprehensive biomarker testing to enable the selection of appropriate targeted therapies and immunotherapy, the incorporation of biomarker testing into clinical practice lags behind recommendations in National Comprehensive Cancer Network guidelines. Coverage policy differences across insurance health plans have limited the accessibility of comprehensive biomarker testing largely to patients whose insurance covers the recommended testing or those who can pay for the testing, and this has contributed to health disparities. Furthermore, even when insurance coverage exists for recommended biomarker testing, patients may incur burdensome out-of-pocket costs depending on their insurance plan benefits, which may also create barriers to testing. Prior authorization for biomarker testing for some patients can add an administrative burden and may delay testing and thus treatment if it is not done in a timely manner. Recently, three states (Illinois, Louisiana, and California) passed laws designed to improve access to biomarker testing at the state level. However, there is variability among these laws in terms of the population affected, the stage of cancer, and whether the coverage of testing is mandated, or the legislation addresses only prior authorization. Advocacy efforts by patient advocates, health care professionals, and professional societies are imperative at the state level to further improve coverage for and access to appropriate biomarker testing.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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State legislative trends related to biomarker testing

Sadigh

Goeckner

Kazerooni

et al. 2022

Cancer

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“…Uptake of both lung cancer screening and molecular testing of lung cancer has been suboptimal. [13][14][15][16] Globally, most clinicians believe that less than half of patients with lung cancer undergo any molecular testing and are not satisfied with the state of molecular testing in lung cancer. 16 Key barriers that have been reported include awareness, access, cost, quality of testing, and turnaround time.…”

mentioning

confidence: 99%

Genie Out of the Bottle: Is There a Role for Gene-Gene Interactions in Early Detection of Lung Cancer?

Smeltzer

Ray

Faris³

et al. 2022

Journal of Thoracic Oncology

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Defining comprehensive biomarker‐related testing and treatment practices for advanced non‐small‐cell lung cancer: Results of a survey of U.S. oncologists

et al. 2021

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Background: An ASCO taskforce comprised of representatives of oncology clinicians, the American Cancer Society National Lung Cancer Roundtable (NLCRT), LUNGevity, the GO 2 Foundation for Lung Cancer, and the ROS1ders sought to: characterize U.S. oncologists' biomarker ordering and treatment practices for advanced non-small-cell lung cancer (NSCLC); ascertain barriers to biomarker testing; and understand the impact of delays on treatment decisions. Methods:We deployed a survey to 2374 ASCO members, targeting U.S. thoracic and general oncologists. Results:We analyzed 170 eligible responses. For non-squamous NSCLC, 97% of respondents reported ordering tests for EGFR, ALK, ROS1, and BRAF. Testing for MET, RET, and NTRK was reported to be higher among academic versus community providers and higher among thoracic oncologists than generalists. Most respondents considered 1 (46%) or 2 weeks (52%) an acceptable turnaround time, yet 37% usually waited three or more weeks to receive results. Respondents who waited ≥3 weeks were more likely to defer treatment until results were reviewed (63%). Community and generalist respondents who waited ≥3 weeks were more likely to initiate non-targeted treatment while awaiting results. Respondents <5 years out of training were more likely to cite their concerns about waiting for results as a reason for not ordering biomarker testing (42%, vs. 19% with ≥6 years of experience).

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Knowledge and Practice Patterns Among Pulmonologists for Molecular Biomarker Testing in Advanced Non-small Cell Lung Cancer

Cited by 18 publications

References 40 publications

State legislative trends related to biomarker testing

State legislative trends related to biomarker testing

Genie Out of the Bottle: Is There a Role for Gene-Gene Interactions in Early Detection of Lung Cancer?

Defining comprehensive biomarker‐related testing and treatment practices for advanced non‐small‐cell lung cancer: Results of a survey of U.S. oncologists

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