Improving Lung Cancer Patient Access to Comprehensive Biomarker Testing

A new awareness campaign developed by the LUNGevity Foundation aims to ensure that there is “No One Missed” in receiving comprehensive biomarker testing and a fully informed diagnosis for the appropriate treatment of patients with lung cancer. [1]

The LUNGevity Foundation is the nation’s leading lung cancer organization focused on improving outcomes for people with lung cancer through research, education, policy initiatives, and support and engagement for patients, survivors, and caregivers

The awareness campaign was created to drive essential comprehensive biomarker testing in non-small cell lung cancer (NSCLC). One of the primary reasons leading to the development of the campaign was that guideline-recommended comprehensive biomarker testing can reveal vital information to help identify the appropriate individualized treatment plan for each NSCLC patient.*

This year more than 235,000 people in the U.S. will be diagnosed with lung cancer this year. [1]

And while NSCLC is a leading cause of cancer deaths in the United States, targeted therapies and immune checkpoint inhibitors have emerged as important new treatment options for these patients.

NCCN guidelines
The guidelines from the National Comprehensive Cancer Network (NCCN) recommend testing of eight genes in NSCLC patients at diagnosis. Targetable alterations in four genes, EGFR, ALK, ROS1, and BRAF, are associated with FDA-approved therapies, some of which have become standard practice, increasing high median survival rates.

And while the development of novel targeted therapies is progressing, showing relatively high objective response rates in some new therapies, data presented during the 2019 annual meeting of the American Society of Clinical Oncology (ASCO), only 22% of eligible patients with advanced NSCLC—one of the two major types of lung cancer—were tested for the biomarkers associated with U.S. Food and Drug Administration (FDA)-approved targeted therapies at the time the research was conducted [2]

Powerful treatment options
Biomarker testing can reveal the presence of driver mutations that can help guide appropriate treatment options for a patient. [1] However, the results from the 2019 study confirm that in the community oncology setting for NSCLC patients genomic testing is underutilized.  And, according to the authors of the study, this directly links to the underutilization of targeted therapies.

With established, overwhelmingly effective biomarker-driven treatments for advanced NSCLC, physicians have powerful tools to help their patients, but, as the study indicated, nearly one-third of the patients with a demonstrated target not only didn’t receive what ideally should be the first-line treatment, but they never received the therapy in the first place.

Tip of the spear
“Lung cancer is at the tip of the spear in precision medicine with advancements happening at an accelerated pace. Lung cancer patients and their providers can look to these fast-paced changes in science to see hope and options for their care,” noted Andrea Ferris, President and Chief Executive Officer of the LUNGevity Foundation.

“Through comprehensive biomarker testing, each patient can receive the appropriate treatment plan for their specific type of NSCLC. That’s why we want to make sure there’s no one missed when it comes to comprehensive biomarker testing in lung cancer—because it’s essential to get a fully informed diagnosis,” she added.

“We hope the entire lung cancer community will focus on making comprehensive biomarker testing part of the diagnosis for every NSCLC patient,” added Nikki Martin, Director of Precision Medicine Initiatives at LUNGevity Foundation.

“Whether you’re a provider, an insurer, a professional society, patient advocacy group, hospital, testing company or lab, or pharmaceutical company, we all play a role in communicating one clear and consistent message about the essential role of comprehensive biomarker testing for lung cancer patients.”

Missing the opportunity
“Without biomarker testing, lung cancer patients may miss the opportunity to receive therapies targeted to their type of lung cancer,” says Christine M. Lovly, MD, Ph.D., Associate Professor of Medicine, Division of Hematology-Oncology, and Ingram Associate Professor of Cancer Research, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center.

“With a rapidly expanding number of FDA-approved, biomarker-driven therapies for NSCLC and new scientific breakthroughs on the horizon for all lung cancers, the role of biomarker testing is critical. There has never been a more important time to bring this message to lung cancer patients and providers.”

Empowering patients and caregivers
The No One Missed campaign will introduce tools to empower patients and caregivers to request comprehensive biomarker testing from their healthcare team at the time of diagnosis, recurrence, or progression, plus a first-of-its-kind lung cancer patient’s bill of rights for accessing and understanding critical biomarker test results to help inform treatment options.

Note: * Data based on EMR and claims data for ~600,000 patients across five community oncology practices. At the time research was conducted, EGFR, ALK, ROS1, and BRAF were the biomarkers with FDA-approved targeted therapies.

References:
[1] American Cancer Society. Cancer Facts & Figures 2021. Atlanta: American Cancer Society; 2021. Last accessed on February 18, 2021.
[2] Gierman HJ, Goldfarb S, Labrador M, et al. Genomic testing and treatment landscape in patients with advanced non-small cell lung cancer (aNSCLC) using real-world data from community oncology practices. J Clin Oncol.2019;37(suppl; abstr 1585).
[3] NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer, Version 5.2019. Online.  Last accessed on February 18, 2021.