Biomarker Turnaround Times and Impact on Treatment Decisions in Patients with Advanced Non-Small Cell Lung Carcinoma at a Large Canadian Community Hospital with an Affiliated Regional Cancer Centre

• Published in: Current oncology (Toronto) 2024-03, Vol.31 (3), p.1515-1528
• Main Authors: Fleming, Katelyn E, Hupel, Ava, Mithoowani, Hamid, Lulic-Kuryllo, Tea, Valdes, Mario
• Format: Article
• Language: English
• Subjects: Biomarkers, Tumor - metabolism; Canada; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Squamous Cell - pathology; Care and treatment; Hospitals, Community; Humans; IHC; lung cancer; Lung cancer, Non-small cell; Lung Neoplasms - drug therapy; molecular testing; NGS; NSCLC; Pemetrexed; Quality of Life; Retrospective Studies; Squamous cell carcinoma
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol31030115

: Timely reporting of molecular biomarkers is critical in guiding optimal treatment decisions in patients with advanced non-small cell lung carcinoma (NSCLC). Any delays along the tissue or treatment pathway may be associated with suboptimal treatment/outcomes and a reduced quality of life. For many centres, biomarkers are tested off-site. A retrospective chart review of 123 patients with advanced NSCLC seen between 1 June 2021 and 30 June 2022 was conducted. With a focus on core biomarkers (PD L1, EGFR, and ALK), the outcome variables were as follows: total turnaround time (total TAT), divided into pre-laboratory, laboratory, and post-laboratory time intervals, as well as time to treatment decision (TOTD) and time to optimal systemic therapy decision (TOTSD). At first consult, only 20.3% of patients had all core biomarker results available. The median total TAT was significantly longer for non-squamous (non-SCC) than squamous cell carcinoma (SCC) specimens (36.5 versus 22 days, < 0.001). The median pre-laboratory time for the entire cohort was 5 calendar days. The median laboratory testing time was greater for non-SCC compared to the SCC specimens (23 versus 12 days, < 0.001). The median time from consult to TOTD was 19 calendar days for the entire cohort. This study emphasizes the need for the expansion of regional resources to meet the clinical needs of advanced NSCLC patients treated at a regional cancer centre which uses an off-site molecular laboratory.