Journal article
Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer
Clinical lung cancer, Vol.24(4), pp.305-312
06/2023
DOI: 10.1016/j.cllc.2023.03.001
PMID: 37055337
Abstract
Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into these differences and their effects on treatment is needed to identify opportunities for improvement.
We conducted a retrospective cohort study of adult patients diagnosed with mNSCLC between 2011 and 2018 using PCORnet's Rapid Cycle Research Project dataset (n = 3600). Log-binomial, Cox proportional hazards (PH), and time-varying Cox regression models were used to ascertain whether molecular testing was received, and time from diagnosis to molecular testing and/or initial systemic treatment in the context of patient age, sex, race/ethnicity, and multiple comorbidities status.
The majority of patients in this cohort were ≤ 65 years of age (median [25th, 75th]: 64 [57, 71]), male (54.3%), non-Hispanic white individuals (81.6%), with > 2 comorbidities in addition to mNSCLC (54.1%). About half the cohort received molecular testing (49.9%). Patients who received molecular testing had a 59% higher probability of initial systemic treatment than patients who were yet to receive testing. Multiple comorbidity status was positively associated with receipt of molecular testing (RR, 1.27; 95% CI 1.08, 1.49).
Receipt of molecular testing in academic centers was associated with earlier initiation of systemic treatment. This finding underscores the need to increase molecular testing rates amongst mNSCLC patients during a clinically relevant period. Further studies to validate these findings in community centers are warranted.
Details
- Title: Subtitle
- Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer
- Creators
- Oyomoare L Osazuwa-Peters - Duke University School of MedicineLauren E Wilson - Duke University School of MedicineDevon K Check - Duke University School of MedicineMegan C Roberts - Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NCSwetha Srinivasan - Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, NCAmy G Clark - Duke University School of MedicineJeffrey Crawford - Duke University School of MedicineElizabeth Chrischilles - University of IowaRyan M Carnahan - University of IowaW Scott Campbell - University of Nebraska Medical CenterLindsay G Cowell - The University of Texas Southwestern Medical CenterRobert Greenlee - Center for Clinical Epidemiology & Population Health, Marshfield Clinical Research Institute, Marshfield, WIAndrea M Abbott - Medical University of South CarolinaAbu S M Mosa - University of MissouriVasanthi Mandhadi - University of MissouriAlexander Stoddard - Medical College of WisconsinMichaela A Dinan
- Resource Type
- Journal article
- Publication Details
- Clinical lung cancer, Vol.24(4), pp.305-312
- DOI
- 10.1016/j.cllc.2023.03.001
- PMID
- 37055337
- NLM abbreviation
- Clin Lung Cancer
- ISSN
- 1525-7304
- eISSN
- 1938-0690
- Grant note
- DOI: 10.13039/100010249, name: School of Medicine, Indiana University; DOI: 10.13039/100013017, name: Vanderbilt University Medical Center; DOI: 10.13039/100007914, name: University of Texas Southwestern Medical Center; DOI: 10.13039/100008893, name: University of Iowa
- Language
- English
- Electronic publication date
- 03/20/2023
- Date published
- 06/2023
- Academic Unit
- Pharmacy; Epidemiology; Nursing; Injury Prevention Research Center
- Record Identifier
- 9984388753902771
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