MYLUNG Study Finds Majority of Patients with Untreated Metastatic NSCLC Tested for at Least One Biomarker

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Lung cancer is the leading cause of cancer death globally, with non–small-cell lung cancer (NSCLC) accounting for 80% to 85% of all lung cancer cases.1 Although pathologically patients may have the same type of NSCLC, patients may experience different responses to treatment due to different cancer genetics.1 Molecular testing has been incorporated into NSCLC diagnostic standards, and treatment based on these test results is an important part of patient management.2 EGFR, BRAF, and MET mutations; ALK, ROS1, RET, and NTRK translocations; and PD-L1 protein expression are all analyzed to direct targeted therapy.2 This approach to individualized precision treatment has led to an improvement in the survival time of patients with advanced NSCLC.1

The Molecularly Informed Lung Cancer Treatment in a Community Cancer Network (MYLUNG) consortium conducted a 2-year retrospective observational chart review study of 3474 adult patients with untreated metastatic NSCLC from 2018 to 2020. Testing rates for ALK, BRAF, EGFR, ROS1, and PD-L1 were assessed along with the use of full next-generation sequencing (NGS) panels. The timing of biomarker testing was used to sort patients into 3 cohorts. Cohort 1 had testing prior to first-line therapy, cohort 2 had testing after first-line therapy, and cohort 3 received no biomarker testing. The median time from metastatic NSCLC diagnosis to receiving biomarker results ranged from 14 to 21 days, with a median turnaround time for testing of 10 to 15 days for the individual biomarkers. The median time from diagnosis to first-line therapy was 5 weeks.

The median age of patients was 69 years with a wide range of 23 to 90 years. Patient population was almost evenly split between males and females, with 51% of the patients being female. A majority (74%) had adenocarcinoma and 76% had Eastern Cooperative Oncology Group performance status of 0 or 1. A least 1 biomarker test was performed in 90% of the patients. All 5 biomarker tests were performed for 46% of the patients. Examination of changes in testing rates during the study period found that testing for all 5 biomarkers increased from 42% to 49%, for BRAF testing it increased from 51% to 59%, and testing rates increased from 82% to 84% for PD-L1. There was also an increase in NGS testing from 33% to 44%. EGFR testing rates remained static at 71%. There were slight decreases in testing rates for ALK (from 71% to 70%) and for ROS1 (from 69% to 67%).

Although most patients received ≥1 biomarker tests before therapy was initiated, <50% of patients received all 5 biomarker tests or NGS testing. The next MYLUNG study will further examine real-world trends in NSCLC biomarker testing.

Source

Robert N, Nwokeji E, Espirito J, et al. Biomarker tissue journey among patients (pts) with untreated metastatic non-small cell lung cancer (mNSCLC) in the U.S. Oncology Network community practices. J Clin Oncol. 2021;39(suppl_5):s9004.

References

  1. Dong J, Li B, Lin D, et al. Advances in targeted therapy and immunotherapy for non-small cell lung cancer based on accurate molecular typing. Front Pharmacol. 2019;10:230.
  2. Imyanitov EN, Iyevleva AG, Levchenko EV. Molecular testing and targeted therapy for non-small cell lung cancer: current status and perspectives. Crit Rev Oncol Hematol. 2021;157:103194.

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