Biomarker Testing for Patients With Advanced/ Metastatic Nonsquamous NSCLC in the United States of America, 2015 to 2021

Introduction: NSCLC is a solid tumor with a growing number of actionable biomarkers that may inform treat-ment. Current guidelines recommend a broad, panel-based approach be taken to identify actionable markers. This retrospective study used a deidentified electronic health records database in the United States to evaluate utilization of various testing modalities.Methods: Data from all adult patients diagnosed with having advanced/metastatic nonsquamous NSCLC between January 2015 and March 2021 were eligible if there was evidence of systemic therapy within 90 days of diagnosis.Results: Records from a total of 17,513 patients (91.6% from community-based practices) were eligible with 83,064 genomic biomarker tests recorded from 2015 to 2021. The proportion of patients who received biomarker testing by next-generation sequencing (NGS)-based methods ranged from 28.3% in 2015 to 68.1% in 2020. The proportion of biomarker testing methods with inconclusive or unsuccess-ful results ranged from 3.4% for NGS to 9.7% for fluores-cence in situ hybridization. The median time to receive results ranged from 4.0 days for polymerase chain reaction -based tests to 10.0 days for immunohistochemistry-and NGS-based tests. Median time to receive results was 8 days for academic and 9 days for community practices.Conclusions: These real-world data suggest increased adoption of NGS-based testing, yet nearly one-third of all patients with advanced/metastatic nonsquamous NSCLC still did not receive broad-based genomic testing by 2020.(c) 2022 The Authors. Published by Elsevier Inc. on behalf of the International Association for the Study of Lung Cancer. This is an open access article under the CC BY-NC-ND li-cense (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).