Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer

Oyomoare L. Osazuwa-Peters, Lauren E. Wilson, Devon K. Check, Megan C. Roberts, Swetha Srinivasan, Amy G. Clark, Jeffrey Crawford, Elizabeth Chrischilles, Ryan M. Carnahan, W. Scott Campbell, Lindsay G. Cowell, Robert Greenlee, Andrea M. Abbott, Abu S.M. Mosa, Vasanthi Mandhadi, Alexander Stoddard, Michaela A. Dinan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into these differences and their effects on treatment is needed to identify opportunities for improvement. Patients and Methods: We conducted a retrospective cohort study of adult patients diagnosed with mNSCLC between 2011 and 2018 using PCORnet's Rapid Cycle Research Project dataset (n = 3600). Log-binomial, Cox proportional hazards (PH), and time-varying Cox regression models were used to ascertain whether molecular testing was received, and time from diagnosis to molecular testing and/or initial systemic treatment in the context of patient age, sex, race/ethnicity, and multiple comorbidities status. Results: The majority of patients in this cohort were ≤ 65 years of age (median [25th, 75th]: 64 [57, 71]), male (54.3%), non-Hispanic white individuals (81.6%), with > 2 comorbidities in addition to mNSCLC (54.1%). About half the cohort received molecular testing (49.9%). Patients who received molecular testing had a 59% higher probability of initial systemic treatment than patients who were yet to receive testing. Multiple comorbidity status was positively associated with receipt of molecular testing (RR, 1.27; 95% CI 1.08, 1.49). Conclusion: Receipt of molecular testing in academic centers was associated with earlier initiation of systemic treatment. This finding underscores the need to increase molecular testing rates amongst mNSCLC patients during a clinically relevant period. Further studies to validate these findings in community centers are warranted.

Original languageEnglish (US)
Pages (from-to)305-312
Number of pages8
JournalClinical Lung Cancer
Volume24
Issue number4
DOIs
StatePublished - Jun 2023

Keywords

  • Time to treatment
  • genomic profiling
  • targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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