In a single-center study reported in JCO Oncology Practice, Ceballos et al identified turnaround times for request and receipt of melanoma BRAF testing results. They also analyzed factors in differences in turnaround times and effects on time to initiation of treatment.
The study included 66 patients with cutaneous or mucosal melanoma at Princess Margaret Cancer Centre, Toronto, who underwent BRAF molecular testing in 2019 and had complete data available. At the time of BRAF testing request, 10 patients (15%) had stage II, 33 (50%) had stage III disease, and 23 (35%) had stage IV disease.
Key Findings
Overall, the median time between BRAF test request and receipt of results was 17 days. The median turnaround time was 12 days (95% confidence interval [CI] = 8–15 days) when the test was ordered by pathology vs 20 days (95% CI = 16–23 days) when ordered by another specialist (P < .001).
When the biopsy and BRAF test were performed within the same institution, the median turnaround time was 13 days (95% CI = 6–19 days) vs 19 days (95% CI = 16–21 days) when the sample was transferred from another institution (P = .02).
This study showed variations in BRAF test results in turnaround times. One factor affecting this timeline is the transfer time, which can be streamlined by pathology reflex testing. Delays in turnaround times affect the timing and type of therapeutic intervention, especially in patients with stage IV disease.— Ceballos et al
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A total of 47 patients received systemic therapy, including 27 in the adjuvant setting and 20 for metastatic disease. Overall, the median time from the first visit with medical oncology to starting treatment was 28 days (95% CI = 21–35 days) if the BRAF result was available at the visit, and 34 days (95% CI = 27–41 days) if the result was not available (P = .097).
Among the 20 patients with metastatic disease, the median time from first visit to start of treatment was 20 days (95% CI = 10–30 days) if the result was available at the first visit vs 31 days (95% CI = 11–51 days) if the result was not available (P = .03). Among the 27 patients receiving adjuvant treatment, the median times were 36 days (95% CI = 23–49 days) vs 34 days (95% CI = 21–47 days, P = .5).
Among seven patients with stage III or IV disease with a BRAF V600 mutation who received targeted therapy, median time to start of treatment was 8 days (95% CI = 0–23 days) if test results were available at the first visit vs 23 days (95% CI = not estimable) if results were not available (P = .4).
The investigators concluded: “This study showed variations in BRAF test results in turnaround times. One factor affecting this timeline is the transfer time, which can be streamlined by pathology reflex testing. Delays in turnaround times affect the timing and type of therapeutic intervention, especially in patients with stage IV disease.”
Diana Paola Arteaga Ceballos, MD, of the Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, is the corresponding author for the JCO Oncology Practice article.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
