x-ray lung cancer
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Value-based precision medicine company Integra Connect, which serves healthcare providers, payers and life sciences companies, announced this week that a retrospective observational study of newly diagnosed, stage 4 non-small cell lung (NSCLC) cancer patients showed that those who received molecular testing prior to treatment selection showed improved survival rates.

The study used data from 525 newly diagnosed stage 4 NSCLC patients who had actionable genetic drivers (AODs) of the disease. The study also leveraged a large de-identified data set of  electronic health records and claims records from a three-year period.

According to Integra Connect’s data analysis roughly 27% of patients (n=141) who began chemotherapy, immune checkpoint inhibitors, or both, before receiving results of any AODs were significantly worse than the remaining 73%, or 384 patients who began treatment after receiving AOD information. These data suggest that newly diagnosed, stage 4 NSCLC patients should receive molecular testing as a measure to improve care quality and patient outcomes.

“This study demonstrates not only the importance of having actionable genomic insights available to inform care decisions, but also the real impact that speed to results has on patient outcomes,” said Garret Hampton, president, Clinical Sequencing and Oncology at Thermo Fisher Scientific, which provided an unrestricted grant to fund the study. “Integra Connect’s validation of this correlation through real-world patient data reaffirms the need to bring genomic testing closer to patients.”

Of the 141 patients treated with chemotherapy (C), immune checkpoint inhibitor (ICI) or both before availability of their AOD results:

  • 51 patients, who subsequently switched to tyrosine kinase inhibitors (TKIs) within 35 days, demonstrated a median apparent survival (AS) of 672 days (day range of 433-1010; HR, 1.719; p-value=0.0090).
  • 90 patients who did not switch demonstrated a median AS of 435 days (day range of 350-560; HR, 2.360; p-value=<.0001)

In the control group of 384 patients who initiated treatment after receiving their AOD results, a median AS was not reached because survival extended beyond the data cut-off date in more than half of patients.

“Results in the control group emphasize the need for near-universal non-squamous testing (as well as squamous never-smokers or age < 40) to inform decision-making as patients who harbor mutations, but are never tested or tested only later, may have significant outcome impairment,” noted a press release from Integra Connect announcing the study results.

Ultra-fast next-generation sequencing (NGS) or liquid biopsy for oncogenic driver NGS testing to minimize turnaround time should be employed to avoid uninformed treatment before mutation report.

Genetic testing has seen significant scientific advancements and extensions into multiple disease areas, including some of the most common cancers, but uptake of genomic testing has been slow and frequently has not employed next-generation sequencing (NGS) panels despite an overall survival benefit with TKIs. In 2020, approximately 1.6 million cases of lung cancers were NSCLC, and of these, 60% to 70% were in advanced stage 4 at the time of diagnosis.

“This study…epitomizes how precision medicine can improve survival in patients with difficult to treat cancers,” said Jeffrey A. Scott, chief medical officer at Integra Connect. “We look forward to sharing these study findings with the medical community and industry colleagues with the goal of working together to improve outcomes in lung cancer patients.”

The findings will be presented as a poster presentation, titled: “Evaluation of outcomes in patients (pts) with stage 4 non-small cell lung cancer (NSCLC 4) harboring actionable oncogenic drivers (AOD) when treated prior to report of mutation without tyrosine kinase inhibitors (TKI): An Integra Connect Database (ICD) retrospective observational study,” available at the Thermo fisher booth at ASCO, June 4-7.

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