Optimizing biomarker testing and targeted therapy integration in early-stage NSCLC: A quality improvement initiative at community oncology clinics.

Abstract

e23223 Background: Treatments for early-stage non-small cell lung cancer (NSCLC) are rapidly evolving, with biomarker testing as a cornerstone of treatment decision-making. However, integrating testing into practice in community settings remains a challenge. Methods: In Feb - April 2024, 60 healthcare professionals (HCPs) from 12 US community oncology clinics in the same network completed surveys to assess practice patterns, barriers, and facilitators related to biomarker testing and targeted therapy in early-stage NSCLC. Baseline chart audits (n = 200) identified current practices and gaps. HCPs participated in a network-wide summit to address underlying root causes of practice gaps, align on key clinical practices, and develop action plans. Follow-up surveys and chart audits assessed practice changes 6 months after the intervention. Results: Eighty-five percent of HCPs felt biomarker assessment in early-stage NSCLC was "very important," but fewer than half of pts received NCCN-recommended biomarker testing (Table 1). Top challenges in identifying eligible pts and incorporating targeted therapies into practice included prioritizing testing with limited tissue (50%), keeping up with the latest guidelines and evidence (43%), and balancing pt comorbidities with toxicities of targeted therapies (37%). HCPs cited that streamlined workflows for testing (27%), financial assistance for testing and/or biomarker-driven therapies (22%), and provider education on evidence for biomarker-directed therapies (20%) would most improve the utilization of biomarker testing and biomarker-directed therapies in early-stage NSCLC. Additionally, only 29% of HCPs reported that every or most pts are discussed in a tumor board. Top barriers to multidisciplinary management included infrequent communication (38%), misalignment on communication methods (38%), and lack of strong inter-specialty relationships (33%). Action plans developed by the HCPs at the summit aimed to streamline workflows for biomarker testing, boost tumor board participation, and improve inter-specialty communication. Following implementation, 71% of HCPs reported increased tumor board use, and 100% agreed the clinic practice changes have led to more early-stage NSCLC patients receiving biomarker testing. Additional follow-up data will be presented. Conclusions: This study identified gaps in biomarker testing and targeted therapy use for early-stage NSCLC in community settings, prompting action plans to improve testing workflows, tumor board utilization, and communication. These methods and findings demonstrate key opportunities to improve multidisciplinary care for pts with early-stage NSCLC. Biomarker testing in early-stage NSCLC. Biomarker HCPs reporting regular testing N=60 Charts With Molecular Testing Results Documentation N=200 EGFR 92% 42% PD-L1 88% 42% ALK 80% 48%