Receipt of Biomarker Testing in Non-Small Cell Lung Cancer: Using Real-World Data to Identify Testing Gaps and Treatment Characteristics
Author(s)
Pamala A. Pawloski, PharmD1, Scott Matthew Myers, MBA2, Cate Lockhart, MS, PharmD, PhD3.
1Principal Research Scientist, AMCP, Apple Valley, MN, USA, 2PearlDiver Inc., Greenwood, IN, USA, 3BBCIC, Asheville, NC, USA.
1Principal Research Scientist, AMCP, Apple Valley, MN, USA, 2PearlDiver Inc., Greenwood, IN, USA, 3BBCIC, Asheville, NC, USA.
OBJECTIVES: The National Comprehensive Cancer Network currently recommends biomarker testing for all patients with newly diagnosed non-small cell lung cancer (NSCLC), especially among those with metastatic disease. Prior studies demonstrate sub-optimal rates of biomarker testing and guideline concordant therapy. We assessed the current biomarker testing landscape among patients diagnosed with NSCLC to better understand which patients are receiving biomarker testing, including genomic and immunohistochemistry testing, and targeted therapy.
METHODS: A longitudinal observational study of patients diagnosed with lung cancer was conducted using a large national multi-payer claims database. We assessed which patients received testing; the targeted therapy received among tested vs. non-tested individuals based on patient demographics, comorbid conditions, and payer type among adult patients with a minimum of 2 lung cancer diagnoses at least 30 days apart.
RESULTS: Of 881,943 cases of lung cancer diagnosed from 2015-2023 from the database, 254,916 (28.9%) received biomarker testing following diagnosis and 33,859 (13.3%) received a targeted therapy following diagnosis. Overall, 15,240 (6.0%) received targeted therapy and biomarker testing following diagnosis. Of those, most (62.5%) patients were female, 46.7% were aged 45-64 years and 47.8% aged 65-89 years, 72.1% had commercial insurance, and 18.0% had Medicare. Receipt of targeted therapy and biomarker testing decreased from 2015-2022 (20.9%-5.8%). The most common targeted therapies received include osimertinib (31.2%), erlotinib (20.8%), afatinib (11.2%), crizotinib (6.9%), alectinib (6.6%), and pembrolizumab (3.5%). Further analyses include the timing of biomarker testing and receipt of targeted therapy relative to diagnosis, and the assessment of comorbid conditions and guideline-concordant therapy among those who received biomarker testing vs. those who did not.
CONCLUSIONS: Among patients with a diagnosis of lung cancer, biomarker testing and receipt of targeted therapy remains low and the combination of testing and treatment decreased over time.
METHODS: A longitudinal observational study of patients diagnosed with lung cancer was conducted using a large national multi-payer claims database. We assessed which patients received testing; the targeted therapy received among tested vs. non-tested individuals based on patient demographics, comorbid conditions, and payer type among adult patients with a minimum of 2 lung cancer diagnoses at least 30 days apart.
RESULTS: Of 881,943 cases of lung cancer diagnosed from 2015-2023 from the database, 254,916 (28.9%) received biomarker testing following diagnosis and 33,859 (13.3%) received a targeted therapy following diagnosis. Overall, 15,240 (6.0%) received targeted therapy and biomarker testing following diagnosis. Of those, most (62.5%) patients were female, 46.7% were aged 45-64 years and 47.8% aged 65-89 years, 72.1% had commercial insurance, and 18.0% had Medicare. Receipt of targeted therapy and biomarker testing decreased from 2015-2022 (20.9%-5.8%). The most common targeted therapies received include osimertinib (31.2%), erlotinib (20.8%), afatinib (11.2%), crizotinib (6.9%), alectinib (6.6%), and pembrolizumab (3.5%). Further analyses include the timing of biomarker testing and receipt of targeted therapy relative to diagnosis, and the assessment of comorbid conditions and guideline-concordant therapy among those who received biomarker testing vs. those who did not.
CONCLUSIONS: Among patients with a diagnosis of lung cancer, biomarker testing and receipt of targeted therapy remains low and the combination of testing and treatment decreased over time.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HSD99
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems, Study Approaches
Disease
Oncology