Biomarker Testing Patterns in Academic and Community Settings Treating NSCLC

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Transcript:

Martin Dietrich, MD, PhD: Dr Sepulveda, maybe we can ask you for your guidance, to comment on some of the testing discrepancies between academic and community settings, some large data sets published, but also maybe some solutions for how we can help to enhance the awareness and implementation in the different settings.

Antonia Sepulveda, MD, PhD: I’m happy to comment on that. I’d like to just step back a little bit and comment also on the approach for biomarker testing. I believe in really taking advantage of all the resources that we may have locally, and this really touches on this follow-up question on community vs academic medical centers. Depending on the complexity of your laboratory and what tests can be performed locally, I am a strong proponent of reflexive testing whenever it’s possible to be done, because that really results in faster turnaround times, economy of tissue, and then if it’s done locally, it can be done in those turnaround times of 7 to 10 days that I think generally work for the clinical setting. But, of course, not every laboratory will be able to do a gene panel that addresses the guideline-recommended biomarkers.

To that end, most studies have really been retrospective. We have certainly seen that over the past several years, there’s been an uptick, and there’s more testing going on. However, testing still is lagging, in particular molecular genomic testing, especially in the community setting as compared with academic medical centers and NCI-designated cancer centers. That’s a very difficult situation to deal with because generally, those laboratories and hospitals that do not have molecular testing in their laboratory are just relying on sending out the tests, and they still have to go through the pathology department, procure the tissue, get the sections, the blocks, review the slides again, and eventually have them sent out. It’s just a very inefficient and long process. This is one of the reasons why I am, whenever possible, in favor of doing reflexive if the institution permits and the pathologist immediately following diagnosis obtaining the unstained sections that need to be cut from the block before exhausting the tissue, and move on for the test to being done. It’s still a very unsatisfactory situation. Generally, for I think EGFR and ALK, the overall rate of testing globally is around 80%, so it’s not terrible. It’s actually worse in other cancers, like colorectal cancer. But when it comes to the more expanded mutation panels, then it dramatically goes down. More needs to be done.

Transcript is AI-generated and edited for clarity and readability.