Clinical studies show positive effects of genomic testing for patients with non-small cell lung cancer

Cancer patients who receive molecular test results before starting first-line treatment for metastatic non-small cell lung cancer (NSCLC) live longer, according to a recently published study by researchers at the University of Pennsylvania. JCO Precision Oncology.

The study was conducted using the electronic medical records of 326 adults, including patients at Florida Cancer Specialists and Research Institute (FCS), who were newly diagnosed with NSCLC between January 2019 and December 2020. Eighty percent of those patients had results. molecular tests performed on tissue or blood samples before starting treatment. The study concluded that patients who had test results prior to first-line treatment survived almost four times longer than patients who did not. According to the published report, the median overall survival for patients with available test results was 24.6 months, compared to 6.2 months for those without results.

Molecular testing can identify genetic mutations and biomarkers that help determine which targeted therapies are most effective in treating certain cancers.

Study author Melina Marmarelis, assistant professor of medicine at the University of Pennsylvania, said: “The study is motivated because we know that molecularly informed treatment can improve survival; Patients with a targeted mutation survive longer if they receive targeted therapy rather than standard chemotherapy or immunotherapy.

In 2021, FCS expanded its advanced genetic testing capabilities to include next-generation sequencing (NGS), which is becoming a standard technology for patients treated at nearly 100 community clinics in the state.

Genetic testing has changed the game in cancer treatment, and this latest study provides further confirmation of its true impact, said Lucio Gordan, MD, FCS president and managing physician. For our oncologists and clinical teams, NGS is the solution that enables us to precisely treat a variety of cancers, enabling informed recommendations for personalized therapies and opening up opportunities for clinical trials based on each patient’s unique outcomes.

The study concluded that the ability to prescribe targeted treatment based on genetic test results often leads to better outcomes. Even patients with progressive disease who cannot wait for results before starting targeted therapy still fare better, as test results provide useful insights into a patient’s prognosis, leading to other treatment options. According to the study, the median overall survival of patients without a therapeutically targetable mutation was 18.2 months, compared with 5.4 months without a result.

The researchers sought to determine whether the National Comprehensive Cancer Network (NCCN) recommendations were associated with molecular genotyping of NSCLC. (1) will improve patient outcomes and also help determine the best ways to test.

NSCLC, one of the two main types of lung cancer, accounts for about 85% of all lung cancers. Slow-growing, it often metastasizes to other parts of the body when diagnosed, making treatment difficult.

Additionally, while the research team emphasized the value of testing blood and tissue simultaneously at diagnosis to speed up the process so that patients and oncologists receive results before treatment, cost and insurance coverage were cited as challenges. While Medicare has covered FDA-approved NGS panel tests for patients with advanced cancer since 2018, reimbursement by commercial payers has been inconsistent. Many states are pushing for broader coverage of biomarker testing. FCS currently has 73% payer coverage for NGS testing and includes most insurances.

The study authors continue to explore the additional benefits of molecular testing for metastatic NSCLC patients and expect their research to provide additional guidance to the oncology community. FCS is proud to be a part of ongoing research efforts that will ensure access, combined with the delivery of timely and targeted therapies, that continue to bring hope to cancer patients.

To get acquainted with the full results of the study:

https://ascopubs.org/doi/full/10.1200/OP.22.00611

• The National Comprehensive Cancer Network (NCCN) recommends comprehensive molecular genotyping prior to first-line therapy for all newly diagnosed patients with metastatic non-small-cell NSCLC.