Impact of Reflexive, Comprehensive Versus Limited Next-Generation Sequencing on Time to Result and Time to Treatment in Advanced NSCLC

Prior studies have explored the impact of reflexive, comprehensive, next-generation sequencing (NGS) testing on time to treatment, detection of actionable mutations, and OS for patients with advanced NSCLC, but reflex testing is not available in many practice settings. Results of a study that evaluated the impact of comprehensive versus limited NGS testing on time to an actionable result and time to treatment were presented at the 2023 North America Conference on Lung Cancer.

The researchers obtained data on 864 patients with a new lung cancer diagnosis between 2019 and 2020, of whom 191 had de novo stage IV NSCLC. The researchers then investigated the frequency of NGS testing and whether patients had comprehensive or limited NGS testing, with comprehensive defined as testing that required an oncologist to order specific oncogene testing.

Results showed that of 106 patients with stage IV NSCLC, 90 (85%) had NGS testing, of whom 29 (32%) had comprehensive testing and 61 (68%) had limited testing completed. The researchers found the median time to actionable results was 26 days for comprehensive testing and 22 days for limited (P=.033). Results also showed the time from first biopsy to initiation of treatment was 37 days for comprehensive testing and 38 days for limited (P=.6).

In conclusion, the researchers commented, “Over a 2-year period, we found that most patients had NGS testing completed and one in three patients had a comprehensive panel sent. While comprehensive testing was associated with significantly longer times to actionable results than noncomprehensive testing, there was no significant difference in time to initiation of treatment. In settings where reflexive, internal molecular testing is not available, these findings support the use of comprehensive molecular profiling in advanced NSCLC.”

Source: Dressler D, Vakkalagadda CV, Sun Z, et al. Impact of comprehensive vs limited NGS on time to result and time to treatment in advanced NSCLC. Abstract of a poster presented at the 2023 North America Conference on Lung Cancer; December 1-3, 2023; Chicago, Illinois.