An Analysis Using a Physician Notes Real-World Database: Biomarker Testing and Targeted Therapy Use Among Patients With NSCLC in the United States

Biomarker testing is crucial in guiding treatment choices by pinpointing individuals who stand to gain from specific regimens, ultimately enhancing patient results. Nevertheless, the application of guideline-endorsed biomarker testing for advanced non–small cell lung cancer (NSCLC) patients varies.

This research delves into the frequency of biomarker testing among NSCLC patients through an in-depth, real-world data analysis.

The Amplity Insights database, which contains transcribed and de-identified records of physician–patient interactions from across the United States, underwent a search and analysis process using natural language processing.

This retrospective analysis focused on patients diagnosed with NSCLC between October 2003 and November 2023. The analysis involved summarizing and describing patient characteristics, biomarker testing, and treatment utilization.

This analysis included 61,018 patients diagnosed with NSCLC. The average age was 69.8 years, with a standard deviation of 10.5 years. Among them, 50.6% were female, and 87.9% identified as White. Additionally, 26.6% of the patients had early-stage disease (stage 0-II), and 73.4% had late-stage disease (stage III-IV). Among the entire cohort, evidence of biomarker testing was observed in 13.4%.

When considering different geographical regions in the United States, 13.3% of patients residing in the West, 11.9% in the Midwest, 16.9% in the Northeast, and 10.6% in the South were biomarker tested. Among patients with late-stage disease, 18.9% were biomarker tested, and the testing rates were higher when considering oncologist records only (24.5%).

Among the patients with a confirmed actionable mutation (6387 patients), 35.9% received a targeted therapy that was appropriately matched to their mutation. Of the patients with actionable mutations, 40.7% had epidermal growth factor mutations, 22.7% had anaplastic lymphoma kinase mutations, and 37.7% were programmed death ligand 1–positive. Among these patients, 35.8%, 17.8%, and 40.2%, respectively, received the appropriate indicated treatment based on the results of the biomarker testing.

These results indicate that biomarker testing is potentially underutilized and that even when conducted, the appropriately targeted intervention may not be used, thus indicating that many patients are not deriving the full benefits of precision therapies.

Regional differences in biomarker testing rates were observed, indicating that other factors, such as social determinants, will likely influence patient access to biomarker testing. This underscores the importance of implementing further educational approaches to enhance precision oncology and improve patient

outcomes.

Source:

Videña V, Iwanyckyj D, Otalora F, Jardim M. Biomarker testing and targeted therapy use among patients with non-small cell lung cancer in the United States: an analysis using a physician notes real-world database. Chicago, IL, & online: presented at 2024 ASCO Annual Meeting; June 3, 2024: abstract 11175.