Optimizing Treatment Outcomes in Advanced NSCLC with Concurrent Biomarker Testing

Zofia Piotrowska, MD, MHS, and Martin Dietrich, MD, PhD, emphasize the crucial role of molecular testing in disease diagnosis, focusing on the significance of rapid turnaround times and the ability of liquid biopsies to address time-sensitive diagnostic needs.

Martin Dietrich, MD, PhD, shares his approach to optimizing the use of diagnostic testing from both a tissue perspective and cost perspective, noting he routinely orders tissue and liquid biopsies during the initial patient visit if prior testing has not been conducted.

Key opinion leaders examine the current National Comprehensive Cancer Network (NCCN) guidelines regarding the utilization of liquid and tissue biopsies, highlighting the necessity for the NCCN to prioritize and recommend concurrent testing as the preferred approach over relying on a single liquid or tissue biopsy alone.

The expert panel underscores the critical importance of rapid diagnostic testing and identification of driver alterations to optimize patient outcomes, given the often-narrow therapeutic window for chemotherapy and targeted therapies.

Medical experts recommend that EGFR, ALK, and PD-L1 testing be performed as reflex tests for patients with early-stage non-small cell lung cancer to inform personalized treatment strategies.

Key opinion leaders highlight findings from a University of Pennsylvania study demonstrating that implementing reflex next-generation sequencing testing can reduce time-to-treatment from 19 days to 10 days, potentially leading to improved overall patient outcomes and survival rates in non-small cell lung cancer.

Zofia Piotrowska, MD, MHS, shares insights into the challenges and advantages of diagnostic testing practices at Massachusetts General Hospital, including the benefits of on-site testing, the need for less streamlined consent forms, and areas for improvement to expedite the diagnostic testing ordering process.

Key opinion leaders delve into the challenges posed by payers, costs, out-of-pocket maximums, and the need for letters of medical necessity, while also addressing additional sources of resistance encountered in clinical practice.

Zofia Piotrowska, MD, MHS, and Martin Dietrich, MD, PhD, emphasize the critical role of both tissue and liquid biopsies, the necessity of rapid time-to-treatment initiation, and the increasing likelihood of liquid biopsies becoming the standard of care for metastatic non-small cell lung cancer patients in the near future.