JCO Precis Oncol. 2025 May;9:e2400449. doi: 10.1200/PO-24-00449. Epub 2025 May 15.
ABSTRACT
PURPOSE: Guidelines recommend biomarker testing and biomarker-informed therapies in patients with metastatic non-small cell cancer (mNSCLC); however, the use remains suboptimal.
METHODS: To understand contemporary testing and treatment patterns, retrospective data from 42,037 patients with mNSCLC in a nationwide electronic health record-derived deidentified database from January 2011 to April 2023 were used to quantify testing rates, test positivity, and use of biomarker-informed therapies, stratified by key demographics to identify potential disparities. Multivariable logistic regression was conducted to include patient characteristics associated with the receipt of biomarker testing and subsequent biomarker-informed therapies.
RESULTS: A total of 34,510 patients (82.1%) received ≥one biomarker test(s). Biomarker testing and use of biomarker-informed therapies increased for all studied biomarkers (EGFR, ALK, ROS1, PD-L1, BRAF, RET, MET) over time, with highest rates observed in 2023: EGFR (88.7% and 79.5%, respectively) and ALK (87.7% and 84.3%, respectively). In multivariate logistic regression, patient sex, race, Eastern Cooperative Oncology Group at baseline, insurance type, smoking status at baseline, and histology were all significantly associated with odds of receiving biomarker testing. Covariates statistically associated with receipt of biomarker-informed therapy varied by biomarker without a clear pattern of association. Although the use of biomarker testing and biomarker-informed therapies has increased in recent years, gaps and potential disparities remain.
CONCLUSION: Analysis of contemporary trends in biomarker testing and use of targeted therapies in mNSCLC in the United States highlight improvements in recent years. However, these rates remain suboptimal in specific strata of the patient population, including differences in racial groups and insurance groups, indicating further work is needed to bridge remaining gaps.
PMID:40373260 | DOI:10.1200/PO-24-00449
