Study findings suggest that patients with advanced/metastatic non–small-cell lung cancer (NSCLC) have improved survival outcomes after receiving treatment that was guided by biomarker testing, according to research presented by Yajun Zhu, MS, MBA, Eli Lilly and Co., Indianapolis, Indiana, and colleagues, at the National Comprehensive Cancer Network (NCCN) 2021 Virtual Annual Conference.

The retrospective observational study used Flatiron Health’s electronic health records data between January 2015 and December 2019, and included patients with non-squamous advanced/metastatic NSCLC. Patients were deemed eligible for inclusion in the study and categorized as “tested” if they received testing for genomic biomarkers, including ALK, EGFR, ROS1 and/or BRAF prior to receiving first-line treatment. Otherwise, patients were categorized as “not tested”.

Ultimately, 13,770 patients (mean age, 68 years) were identified, with most (82.6%) testing for 1 of the 4 biomarkers before initiating first-line therapy. Factors associated with testing included smoking status, gender, body mass index, performance status, stage at initial diagnosis, year of advanced diagnosis, practice site, and hospital’s practice volume (all P <0.05).

After further categorizing patients into 4 groups, the hazard death was 17% lower in patients in the “tested-positive-concordant” group, or patients who were tested positive for a biomarker after receiving NCCN-recommended fist-line treatment, compared to those in the “tested-positive-discordant” group, or patients who were tested positive for a biomarker, but did not received NCCN-recommended first-line treatment (adjusted hazard ratio [aHR], 0.83; 95% CI, 0.80-0.86). The adjusted hazard of death was nearly double (50%) in patients in the “not tested” group compared with patients in the “tested-positive-discordant” group (aHR, 1.50; 95% CI, 1.46-1.55).

“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,” Zhu concluded.—Emily Bader

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 NCCN 2021 Virtual Annual Conference; March 18-20,2021; Virtual. Abstract CGE21-031.