Citation: Journal of Throacic Oncology. 2020 May 14;S1556-0864(20)30383-X. Online ahead of print.
Author: Matthew P Smeltzer, Murry W Wynes, Sylvie Lantuejoul, Ross Soo, Suresh S Ramalingam, Marileila Varella-Garcia, Meghan Meadows Taylor, Kristin Richeimer, Kelsey Wood, Kristen E Howell, Mercedes Lilana Dalurzo, Enriqueta Felip, Gina Hollenbeck, Keith Kerr, Edward S Kim, Clarissa Mathias, Jose Pacheco, Pieter Postmus, Charles Powell, Masahiro Tsuboi, Ignacio I Wistuba, Heather A Wakelee, Chandra P Belani, Giorgio V Scagliotti, Fred R Hirsch
Abstract: Introduction: Access to targeted therapies for lung cancer depends on accurate identification of patients' biomarkers through molecular testing. 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 healthcare professionals around the world. The survey included a 7-question introduction for all respondents, who then answered according to one of three tracks: requesting tests/treating patients, performing/interpreting assays, or tissue acquisition. Barriers to implementing molecular testing were provided in free-response fields. The Chi-squared test was used for regional comparisons.
Results: 2,537 respondents from 102 countries participated. Most respondents testing/treating patients believe <50% of lung cancer patients in their country receive molecular testing, but report higher rates within their own practice. Although many results varied by region, the five most frequent barriers cited in all regions were cost, quality/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/interpreting assays. Issues identified included trouble understanding results (37%) and quality of the samples (23% report >10% rejection rate). Despite concerns regarding quality of testing, 47% in the performing/interpreting track stated there is no policy or strategy to improve quality in their country. Additionally, 33% of respondents who request tests/treat patients were unaware of the most recent CAP/IASLC/AMP guidelines for molecular testing.
Conclusions: Adoption of molecular testing for lung cancer is relatively low across the world; barriers include cost, access, quality, turn-around time, and lack of awareness.
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