Genomic testing in newly diagnosed patients with metastatic non small cell lung cancer (NSCLC): A report from a single centre within the Kaleido registry.

Abstract

e13554 Background: The genomic testing rates in community oncology practices have been reported as low compared to academic centers, results mainly based on data from systems that passively ingest data from Electronic Health Records (EHRs). In the Kaleido Registry, all patients with non-small cell lung cancer (NSCLC) are consented for comprehensive abstraction prior to each visit, providing a systematic and unbiased pre-screening for clinical trials. Given this comprehensive and systematic approach, reliable data on genomic testing rates and patient characterization can be generated. We report the results of data collected from March 2024 to date in one community-based oncology practice. Methods: All patients with a suspected or confirmed lung cancer diagnosis and a scheduled visit to the practice were abstracted according to defined criteria prior to each visit. A mechanism to report newly diagnosed patients with metastatic disease to the site was established. Genomic testing was ordered as part of standard clinical care. Results: From March 25th to Oct 8th, 2024, 59 patients newly diagnosed with metastatic NSCLC were identified (F/M:26/33, squamous/non-squamous 51/8). Testing rate for EGFR, ALK, ROS1 alterations exceeded 90% with just over a third of patients having genomic testing based on liquid biopsy alone. The median time from establishment of metastatic disease to genomic testing results was 25 days. No genomic testing was associated with squamous histology. A wide range of NGS assay providers were used and the rate of actionable genomic alterations were consistent with those reported in the literature. PD-L1 expression assessment was performed in 76% of patients with a median time from date of metastatic disease to report of results of 26 days. Conclusions: The results show higher rates of genomic testing in newly diagnosed patients with metastatic NSCLC than what has previously been reported from the community oncology setting (typically below 70%). The proportion of patients having liquid biopsy assessment is in line with the proportion of patients with limited residual tumor material available for tissue-based genomic testing in NSCLC. The systematic approach to identifying patients and ordering testing may have positively impacted testing rates which may translate into improved and more informed patient care.