Treatment guided by biomarker testing is associated with improved survival outcomes in patients with advanced or metastatic NSCLC, according to a recent study presented at the virtual NCCN 2021 Annual Conference.

Yajun Zhu MS, MBA, Eli Lilly and Company, Indianapolis, IN, and colleagues conducted a retrospective study identifying factors associated with genomic biomarker testing and examining the association of testing-guided treatment with survival outcomes in patients with advanced/metastatic NSCLC.

Electronic health records from the Flatiron Health database were used to identify 13,770 eligible patients with non-squamous advanced/metastatic NSCLC. Patients were divided into two groups: “tested” and “not tested.” Patients were considered “tested” if they received testing for genomic biomarkers including ALK, EGFR, ROS1, and/or BRAF prior to receiving first-line treatment, and “not tested” if otherwise. 

Patients were further divided into four groups: (1) “tested-positive-concordant” (patients who were tested positive for a biomarker and received NCCN-recommended first-line treatment), (2) “tested-positive-discordant” (patients who were tested positive for a biomarker but did not receive NCCN-recommended first-line treatment), (3) “tested-but no positive results” (those who did not have a positive biomarker result), and (4) “not tested.”

Factors associated with testing as well as the association between testing-guided treatment with survival outcomes in patients were examined using logistic regression and inverse weighting cox regression models.

Of those included in this study, 82.6% were tested for one of the four biomarkers before initiating first-line treatment. Smoking status, gender, body mass index, performance status, stage at initial diagnosis, year of advanced diagnosis, practice site and hospital’s practice volume were some of the factors associated with testing.

The hazard of death was 17% lower in patients in the “tested-positive-concordant” group versus the “tested-positive-discordant” group. For those in the “not tested” group, the hazard of death was 50% higher when compared to those in the “tested-positive-discordant” group.

“Real world data suggest that receipt of treatment that is guided by biomarker testing results is associated with improved survival outcomes in this patient population” concluded Dr Zhu and colleagues.—Marta Rybczynski

Zhu Y, Han Y, Bhandari NR, et al. Genomic Biomarker Testing, Treatments, and Survival Outcomes Among Patients With Advanced or Metastatic NSCLC in the US: A Retrospective Cohort Study. Presented at: the virtual 2021 NCCN Annual Conference; March 18-20, 2021. Abstract CGE21-031.