“We know that molecular alterations on gene mutations such as EGFR and ALK can lead to better prognosis, better response rates, and, more important, better quality of life for patients,” said Joshua K. Sabari, MD, of NYU Langone Health Perlmutter Cancer Center, who discussed the abstract at the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung Cancer. “We also know that PD-L1 expression can lead to prediction of response to immunotherapy.”

Joshua K. Sabari, MD

“Understanding these biomarkers in patients with lung cancer is critical to match them to the best possible therapies,” Dr. Sabari continued. “We now understand that multiple different driver alterations make up the heterogeneity that is NSCLC [non–small cell lung cancer], and understanding what mutation is harbored in your cancer may then guide you to the best possible treatment.”

More on Survey Outcomes

With respect to the survey outcomes, Dr. Sabari noted that most responding oncologists cared for fewer than 50 patients per month with NSCLC, which is “far different from what is seen in the academic setting.” Dr. Sabari also highlighted the diverse insurance status of patients being treated by survey respondents. Whereas some patients had no insurance, he said, others had Medicaid or different private insurance plans.

“Unfortunately, insurance status is a very important factor in determining what biomarker testing is available for our patients,” Dr. Sabari said.

Survey results showed that just 25% of physicians surveyed felt “extremely confident” in the 2018 CAP/IASLC/AMP molecular testing guidelines for lung cancer. According to Dr. Sabari, however, the fact that 50% of physicians were only “slightly confident” or had not even heard of molecular testing guideline recommendations was “more concerning.”

“When meeting a new patient with NSCLC in the clinic, it’s critical to understand the driver alteration, not only for prognosis but also for goals-of-care discussion as well as potential treatment options,” said Dr. Sabari. “In addition to developing impactful education materials, we need to develop better tools for improving patient-clinician discussions about biomarker testing.” 

DISCLOSURE: Dr. Sabari reported financial relationships with AstraZeneca, Genentech, Janssen, Navire, Pfizer, Regeneron, Sanofi Genzyme, and Takeda.