Lung Cancer Molecular Testing Rates Similar Across Patient Age-Groups

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Molecular testing for patients with advanced lung cancer identifies those who may benefit from immunotherapy or targeted therapy.1 Management guidelines recommend that molecular testing should be performed at the time of initial diagnosis, or when disease progression occurs when the patient is on targeted therapy.1 However, real-world evidence shows that molecular testing is frequently not performed at initial diagnosis or the patient does not have molecular testing at any stage during the disease process.1 This may result in patients with lung cancer not receiving appropriate treatment or having treatment delayed with devastating consequences.1

Lamy and colleagues investigated whether patients aged ≥70 years with advanced/metastatic nonsquamous non–small-cell lung cancer (NSCLC) had molecular testing performed at the same proportions as younger patients. The results of their retrospective analysis were presented at the European Society for Medical Oncology 2021 Congress. The analysis was performed using a French multicenter real-life database to identify patients diagnosed with advanced or metastatic NSCLC between 2015 and 2018. Patients had ≥1 mutation tests performed within 1 month before or 3 months after they were diagnosed. There were 2848 patients aged ≥70 years and 6900 patients aged <70 years included in the study, with a median age at diagnosis of 64 years. The majority (63%) of patients were male and the major (83%) cancer subtype was adenocarcinoma. Patients who were current smokers at diagnosis made up 17% of the ≥70 years cohort and 42% of the <70 years cohort.

Analysis of the proportion of molecular testing performed between the 2 age-groups revealed no significant difference. Molecular testing was performed for 63% of the ≥70 years cohort and 65% of the <70 years cohort. The ≥70 years group had a higher rate of EGFR mutations (22% vs 12%) while the <70 group had a higher rate of KRAS mutations (37% vs 31%). Other oncogenic driver mutations were similar between the age-groups. Over time, the proportion of molecular testing performed at time of diagnosis increased for both cohorts. Age was not found to be a barrier to receiving molecular testing in this study. The analysis did find that female gender, smoking status, and adenocarcinoma were factors associated with molecular testing.


Lamy T, Cabarrou B, Planchard D, et al. Molecular testing in older patients treated for an advanced or metastatic non-squamous non-small cell lung cancer. Ann Oncol. 2021;32(suppl_5):S1237-S1256.


  1. Gregg JP, Li T, Yoneda KY. Molecular testing strategies in non-small cell lung cancer: optimizing the diagnostic journey. Transl Lung Cancer Res. 2019;8:286-301.

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