Elsevier

Journal of Thoracic Oncology

Volume 15, Issue 9, September 2020, Pages 1434-1448
Journal of Thoracic Oncology

Original Article
Outcomes Research
The International Association for the Study of Lung Cancer Global Survey on Molecular Testing in Lung Cancer

https://doi.org/10.1016/j.jtho.2020.05.002Get rights and content
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Abstract

Introduction

Access to targeted therapies for lung cancer depends on the accurate identification of patients’ biomarkers through molecular testing. The International Association for the Study of Lung Cancer (IASLC) conducted an international survey to evaluate perceptions on current practice and barriers to implementation of molecular testing.

Methods

We distributed the survey to IASLC members and other health care professionals around the world. The survey included a seven-question introduction for all respondents, who then answered according to one of three tracks: (1) requesting tests and treating patients, (2) performing and interpreting assays, or (3) tissue acquisition. Barriers to implementing molecular testing were provided in free-response fields. The chi-square test was used for regional comparisons.

Results

A total of 2537 respondents from 102 countries participated. Most respondents who test and treat patients believe that less than 50% of patients with lung cancer in their country receive molecular testing, but reported higher rates within their own practice. Although many results varied by region, the five most frequent barriers cited in all regions were cost, quality and standards, access, awareness, and turnaround time. Many respondents expressed dissatisfaction with the current state of molecular testing for lung cancer, including 41% of those performing and interpreting assays. Issues identified included trouble understanding results (37%) and the quality of the samples (23% reported >10% rejection rate). Despite concerns regarding the quality of testing, 47% in the performing and interpreting track stated there is no policy or strategy to improve quality in their country. In addition, 33% of respondents who request tests and treat patients were unaware of the most recent College of American Pathologists, IASLC, and Association for Molecular Pathology guidelines for molecular testing.

Conclusions

Adoption of molecular testing for lung cancer is relatively low across the world. Barriers include cost, access, quality, turnaround time, and lack of awareness.

Keywords

Molecular testing
Targeted therapy
EGFR
ALK

Cited by (0)

Disclosure: Dr. Smeltzer is a research consultant for the Association of Community Cancer Centers. Dr. Belani reports receiving other fees from Genentech and Takeda. Dr. Felip reports receiving personal fees from AbbVie, AstraZeneca, BergenBio, Blue Print Medicines, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Guardant Health, Janssen, Medscape, Merck, Merck Sharp & Dohme, Novartis, Pfizer, priME Oncology, Roche Holdings AG, Samsung, Takeda, and Touchtime; and has a Board Membership in Grífols. Dr. Hirsch reports receiving other assistance from AstraZeneca, Roche/Genentech, Daiichi, Merck, OncoCyte, Bristol-Myers Squibb, and Novartis; and has a patent for EGFR Protein and Gene Copy Number as Predictive Biomarkers for EGFR inhibitors issued. Dr. Lantuejoul reports receiving personal fees from AstraZeneca, Merck Sharp & Dohme, Bristol-Myers Squibb, Bayer, and AbbVie. Dr. Pacheco reports receiving personal fees from AstraZeneca, Gerson Lehrman Group, Hengrui Pharmaceuticals, Novartis, Pfizer, Genentech, and Takeda; and grants from Pfizer. Dr. Postmus reports receiving grants and personal fees from Boehringer Ingelheim; and personal fees from AstraZeneca, Seattle Genetics, Eli Lilly, Merck Sharp & Dohme, and Chiesi. Dr. Powell reports receiving personal fees from Nucleix, Daiichi-Sankyo, AstraZeneca, and Siemens. Dr. Ramalingam reports receiving personal fees from Amgen, AbbVie, Bristol-Myers Squibb, Genentech, Eli Lilly, and Loxo Takeda; and grants from Merck, Tesaro, and AstraZeneca. Dr. Scagliotti reports receiving personal fees from Eli Lilly, Roche, Pfizer, AstraZeneca, Merck Sharp & Dohme, Novartis, and Takeda. Dr. Soo reports receiving grants and personal fees from AstraZeneca and Boehringer Ingelheim; and personal fees from Bristol-Myers Squibb, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Taiho Pharmaceutical, Takeda, Yuhan, and Amgen. Dr. Tsuboi reports receiving grants from Boehringer Ingelheim, Japan; grants and personal fees from AstraZeneca, Bristol-Myers Squibb, Merck Sharp & Dohme; and personal fees from Eli Lilly, Chugai Pharmaceutical Co., Ltd., Taiho Pharma, Johnson & Johnson, Ethicon, Japan, Medtronic, Teijin Pharma, and Daiichi-Sankyo. Dr. Wistuba reports receiving grants and personal fees from Genentech/Roche, Bayer, Bristol-Myers Squibb, AstraZeneca/Medimmune, Pfizer, HTG Molecular, Merck, and Guardant Health; grants from Oncoplex, DepArray, Adaptive, Adaptimmune, EMD Serono, Takeda, Amgen, Karus, Johnson & Johnson, Iovance, 4D, Novartis, OncoCyte, and Akoya; and personal fees from GlaxoSmithKline and Merck Sharp & Dohme. Dr. Dalurzo reports receiving personal fees from Pfizer, Roche, Takeda, and Novartis. Dr. Kerr reports receiving personal fees from Astra Zeneca, Amgen, Roche, Bristol-Myers Squibb, Merck Sharp & Dohme, Merck Serono, Pfizer, Boehringer Ingelheim, and Bayer. All relationships reported are outside of the submitted work. The remaining authors declare no conflict of interest.