Evolving genetic testing and treatment pathways in non-small cell lung carcinoma: a Healthcare Professional survey of current practices in the UK
Baijal, S. Crosbie, P. Fenemore, Jackie Desai, K.
Baijal, S.
Crosbie, P.
Fenemore, Jackie
Desai, K.
Citations
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Abstract
The treatment of non-small cell lung carcinoma (NSCLC) has
changed significantly in recent years with the discovery of new oncogenic mutations and the introduction of immunotherapy. In
March-June 2021 we conducted 57 interviews with healthcare
professionals (HCPs) involved in the secondary care management of
patients with NSCLC (39 oncologists, 10 nurses, 5 pathologists, 3
respiratory physicians) representing geographically dispersed NHS
Trusts across the UK. The aim was to understand the current UK
NSCLC patient pathway in relation to oncogenic mutation testing
practices, treatment preferences as well as anticipated future trends.
In terms of genetic testing, a variety of tests were commonly
performed although the testing location varied. 47% (n=27) of
respondents represented hospitals that performed genetic testing
onsite, 30% (n=17) offsite, and 23% (n=13) at a genomic laboratory
hub. Genetic tests perceived to be clinically relevant despite not
currently being accessible or reimbursed included MET and HER-2
(Fig. 1). In terms of treatment preferences, in an adjuvant setting,
respondents (n=46) estimated a median of 20.0% (IQR 10.0%-30.0%)
of eligible patients decline chemotherapy despite being fit enough
to receive it. Declining treatment in metastatic NSCLC was estimated
to be 17.5% (10.0%-30.0%; n=46) for second/third line treatment. The
most common reason for declining treatment was perception on
impact on quality of life (89%, n=50/56). The survey highlights
variance in mutation testing practices across the UK, which may
impact diagnosis and treatment decisions, and in turn may
contribute to health outcome inequalities. Molecular driven
treatments tend to be better tolerated; as biomarker testing expands
and targeted options become available, more patients may be willing
to accept treatment. Insights suggest that future areas of clinical
interest in NSCLC are MET, HER-2, KRAS and personalised neo/
adjuvant therapies. The survey results conclude there are a number
of areas of unmet need remaining within the NSCLC patient pathway.
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Baijal S, Crosbie P, Fenemore J, Desai K. Evolving genetic testing and treatment pathways in non-small cell lung carcinoma: a Healthcare Professional survey of current practices in the UK. Vol. 165, Lung Cancer. Elsevier BV; 2022. p. S5.