Registry Study Shows a Real-World Increase in Biomarker Testing Among Patients With Advanced NSCLC

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More than half of patients diagnosed with advanced non–small cell lung cancer (NSCLC) undergo biomarker testing, and this figure has increased over the past 5 years, according to real-world data from a Spanish national registry study reported by Calvo de Juan et al at the European Lung Cancer Congress (Abstract 39P). The results of this study illustrate the value of registry data for improving lung cancer care.

“The overall survival of patients with lung cancer has increased by around 15% over the past decade, primarily because we now have new therapies, including targeted drugs. To use these therapies, we need to determine the molecular biomarkers on a patient’s tumor. Our study analyzed the rate of this molecular testing in real-world clinical practice,” explained lead author Virginia Calvo de Juan, MD, of Hospital Universitario Puerta de Hierro-Majadahonda, Madrid.

Thoracic Tumors Registry Analysis

The study assessed biomarker testing in the Thoracic Tumors Registry, an observational, prospective registry in Spain that included data for 9,239 patients diagnosed with stage IV NSCLC from 2016 to date. “Results showed that tumor biomarker testing was performed in 85% of patients with nonsquamous tumors and 56.3% of those with squamous tumors, and that’s important for making treatment decisions,” reported Dr. Calvo de Juan. Nearly half (44.5%) of patients undergoing testing had a positive result for either EGFR, ALK, KRAS, BRAF, ROS1, or PD-L1. The registry analysis showed a significant increase in all molecular testing over the past few years.

“The key message is that it is very important to have a registry to collect information on real-life cancer care. We can’t do better if we don’t have a clear idea of what we are doing in routine clinical practice,” suggested Dr. Calvo de Juan. She noted that 182 hospitals across Spain participate in the Thoracic Tumors Registry.

“The Spanish Group is one of the best study groups in Europe and is very committed to providing targeted treatments to [patients with] lung cancer,” commented Rolf Stahel, MD, President of the European Thoracic Oncology Platform. “Analyzing the registry data shows a very high rate of molecular testing over a 5-year period,” he said. He considered that it would be helpful to also look at how frequently molecular testing resulted in individual patients receiving appropriate targeted treatment.

“Cancer registries are very important in improving outcomes for … patients for several reasons,” explained Dr. Stahel. “First, they can be useful to improve the standard of patient care.” A population-based or hospital-based registry collects data on patients that can then be analyzed for particular aspects of cancer diagnosis, treatment, and outcomes. “You can then look at how a particular hospital or region is performing, benchmark against other populations, and see where you stand and how you can improve.” Second, cancer registries can provide a way of studying treatment effects in very rare cancers where there are too few patients to perform randomized trials.

The European Society for Medical Oncology has collaborated with the International Agency for Research on Cancer and institutions to build a population-based registry in lung cancer in Asian countries, including regions of Malaysia, Thailand, Indonesia, and a clinical registry in Singapore. The first question the registry analyzed was the proportion of patients with a pathologic diagnosis or a clinical diagnosis, before looking at molecular testing for available targeted drugs. “The results were very heterogeneous between these countries,” Dr. Stahel noted. “The current step consists in identifying the gaps that lead to variations in care and how health-care providers can be supported to address these gaps.”

He concluded, “By supporting cancer registries, we can help to support the dissemination of advances in cancer care across different regions to improve treatment and ensure that all patients can benefit.”

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