OneOncology, a national platform for independent community oncology practices, and Genentech, a member of the Roche Group, presented data in two abstracts at the 2021 ASCO Quality Care Symposium examining genomic profiling and biomarker testing patterns in community oncology centers, as part of their multi-year strategic research partnership. Bringing personalized cancer treatment to patients in community cancer centers requires biomarker and next generation sequencing (NGS) to identify actionable mutations and improve the time to targeted treatment. Thus, understanding testing patterns at different sites of care is an important component of increasing patient access to targeted therapies for some advanced cancers.
“Biomarker and next generation sequencing are the backbone of personalized treatments in oncology,” says Lee Schwartzberg, MD, chief medical officer of OneOncology. “Understanding current testing patterns and strategies to increase their uptake is a vital component to bring precision medicine to oncology practices across the country. These research presentations identify an important baseline for how the physicians on the OneOncology platform are bringing advanced diagnostics to their clinic and how we can improve future utilization.”
One real-world data study evaluated NGS testing patterns for advanced non-small cell lung cancer (NSCLC) and metastatic breast cancer at four OneOncology practices that use Flatiron Health’s OncoEMR electronic health record (EHR).
At the four OneOncology sites, 63% of patients (2,045 of 3,221) with non-small cell lung cancer received NGS testing with or without other genetic profile testing. This is compared to 46% of patients (13,681 of 29,572) in the broader nationwide Flatiron EHR-derived de-identified NSCLC database. For metastatic breast cancer, the findings were 40% (513 of 1,295) as compared to 20% (2,458 of 12,175).
While adoption of NGS differed by cancer type and NGS testing rates increased over time in both advanced cancers, the data showed OneOncology had a higher NGS uptake with a shorter time to testing in metastatic breast cancer, possibly related to their network-wide strategy recommending NGS testing at diagnosis of advanced disease. Researchers say further studies are needed to improve the actionability of NGS testing to foster personalized treatment decisions. A second real-world data study examined testing for six selected biomarkers (ALK, EGFR, BRAF, ROS-1, PDL-1, KRAS) and targeted treatment patterns among 3,860 advanced non-small lung cancer patients at four OneOncology sites of care. Patients who received all six biomarker tests increased from 13% in 2015 to 57% in 2020. The study demonstrates a favorable increase in advanced lung cancer biomarker testing over time at OneOncology sites. Among the tested patients, the median time from advanced diagnosis to the first test result was 20 days. And the time from specimen collection after advanced diagnosis to the first test result was 13 days. Of 1,207 patients with a NSCLC with actionable mutations, 390 (32%) received treatment before receiving their test results.
“The insights from this research collaboration will help to inform opportunities to improve care in biomarker testing for patients and to identify best practices in community oncology practices to truly personalize care for patients,” says Jamie Freedman, MD, PhD, and head of U.S. medical affairs for Genentech. “For example, shortening the turnaround time of NGS tests may allow more patients who have actionable mutations receive appropriate treatment by reducing the number of patients who will start treatment prior to receiving test results. Furthermore, these real-world studies will prepare us for future research to improve the value of personalized care.”
