Precision Medicine in Spain: A Real-World Study on Biomarker Testing Rates Across Spanish Regions

OBJECTIVES: This study aims to understand the status of precision medicine in Spain through the analysis of the access to and use of biomarker testing across regions.

METHODS: A large sample of 4,195 patients diagnosed in Spain with non-small cell lung cancer (NSCLC), colorectal cancer (CRC) and breast cancer (BC), and under pharmacological treatment, available in Oncology Dynamics^TM (a cross-sectional database with national representativeness about real clinical practice) between October/2022 and September/2023 was analyzed. Testing rates were reviewed for six biomarkers recommended to be tested by guidelines in three tumor types for these patients: PDL1 for NSCLC, ALK and ROS1 for advanced/metastatic NSCLC, MMR/MSI for CRC, BRAF for advanced/metastatic CRC and PIK3CA for advanced/metastatic HR+/HER2- BC patients. Data was stratified in five regions: Central, North-West, North-East, East, and South. In addition, seven Spanish leading experts in precision medicine were interviewed to understand the current and future implementation process of precision medicine in the clinical practice.

RESULTS: Out of the biomarkers analyzed, the highest testing rate at national level was observed for PDL1 in NSCLC (86.8%). For the rest, testing rate in the populations in scope was ≥70% in all cases except for PIK3CA in HR+/HER2- advanced/metastatic BC patients, which decreases to 19.6%. Differences between regions were detected, especially for BRAF in advanced/metastatic CRC (testing rate range 49.2-89.8%), and ALK in advanced/metastatic NSCLC (testing rate range 65.6-90.5%).

CONCLUSIONS: This study showcases that even if there is an extensive adoption of precision medicine in Spain, testing rate is far from 100% in most of the populations in scope, in addition to the existence of variations across different regions in the country.