Despite progress, barriers to lung cancer biomarker testing persist
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Acceptance and utilization of lung cancer biomarker testing has increased in the past 6 years, but key barriers persist, according to survey results.
The data — presented at International Association for the Study of Lung Cancer (IASLC) World Conference on Lung Cancer — revealed cost, time and sample quality as the most common testing obstacles.
“The survey’s findings reflect both the progress made and the work still needed to ensure that biomarker testing becomes a standard part of lung cancer care worldwide,” Matthew P. Smeltzer, PhD, MStat, associate professor in the division of epidemiology, biostatistics and environmental health at University of Memphis, said in a press release.
Background and methods
Biomarker testing can identify mutations in specific oncogenes that cause cancer cells to divide and grow. The findings can be used to match patients to appropriate targeted therapies that are most likely to extend survival or improve other outcomes.
However, implementation of biomarker testing in lung cancer has been “suboptimal,” Smeltzer said.
The IASLC conducted a survey in 2018 to evaluate lung cancer biomarker testing practices. Findings showed low adoption at that time due to several factors, including awareness, access, cost, lack of quality and standards, and lengthy turnaround time for results.
Given the advances in treatment for early-stage and late-stage lung cancer since then, IASLC and its partners conducted another global survey this spring, with the intention of using the data to develop a resource guide on next-generation sequencing testing implementation.
Researchers administered a primarily quantitative survey to evaluate demographics, current practices, barriers to optimal testing and potential solutions. They categorized responses by global region and median income of each country.
Investigators also conducted qualitative focus groups and in-depth interviews to inform survey results.
Key findings
The analysis included 1,677 evaluable responses from clinicians in 90 countries. Survey respondents represented 14 disciplines, the most common of which included medical oncologists, pathologists, thoracic surgeons and pulmonologists.
Two-thirds (67%) of respondents reported more than half of patients with lung cancer in their respective countries are tested, a considerable improvement from the 39% rate reported in the 2018 survey.
The most common barriers to testing identified by survey respondents included cost (27.2%), time (13.9%), sample quality (13.8%), access (12.8%) and awareness (8%). The barriers appeared similar regardless of patients’ disease stage.
In addition, 43% of respondents indicated they sometimes or often treat patients prior to receiving biomarker testing results.
Other key findings showed:
- 98.3% of respondents believe biomarker testing significantly affects outcomes;
- 91.2% say they have “a clear understanding” of who should undergo testing;
- 63.4% consider it “highly important” to perform biomarker testing for patients with late-stage lung cancer, and 29.4% consider it “highly important” to do so for patients with early-stage disease;
- 25% indicated they receive full reimbursement for all biomarker tests, whereas the majority reported partial reimbursement (37%), limited reimbursement (18%) or no reimbursement (13); and
- Respondents reported a median turnaround for tissue testing of 14 working days, with no consensus on explanations for the delay.
Survey respondents identified several potential strategies to improve biomarker testing. These included greater education for patients and providers, greater funding from insurance and governmental entities, and implementation of testing protocols.
IASLC intends to launch a series of initiatives to target policy improvements, access, processes and awareness, Smeltzer said.
References:
- IASLC Global Survey on biomarker-testing reveals progress and persistent barriers in lung cancer biomarker testing (press release). Published Sept. 7, 2024. Accessed Sept. 7, 2024.
- Smeltzer M, et al. Abstract 3000. Presented at: World Conference on Lung Cancer; Sept. 7-10, 2024; San Diego.
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Smeltzer M, et al. Abstract 3000. Presented at: IASLC World Conference on Lung Cancer; Sept. 7-10, 2024; San Diego.
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