Dr Levy on the Correlation Between Upfront NGS and OS Benefit in NSCLC

Benjamin Philip Levy, MD, associate professor, oncology, Johns Hopkins University School of Medicine; clinical director, Medical Oncology, Johns Hopkins Sidney Kimmel Cancer Center, Sibley Memorial Hospital, discusses the relationship between upfront next-generation sequencing (NGS) and survival outcomes in non–small cell lung cancer (NSCLC).

A real-world, retrospective study was designed to assess current genomic testing strategies and determine whether NGS was associated with an overall survival (OS) advantage vs other non-NGS approaches in this space, Levy begins. The study utilized data from the Flatiron electronic health record (EHR) database of patients with stage IIIB to IV NSCLC who were diagnosed between April 11, 2019, and December 31, 2021, and received systemic therapy, he details.

A total of 13,139 patients were included in the overall study population. These patients were observed from their date of diagnosis until May 31, 2022. Information was gathered regarding the genetic testing methods they underwent prior to the initiation of first-line therapy. Non-NGS tests consisted of genomic sequencing methods that did not feature NGS in their name, such as polymerase chain reaction, fluorescence in situ hybridization, or immunohistochemistry.

Results showed that patients who received upfront NGS testing had better OS outcomes vs those who had not received any genomic testing or received NGS later on in the disease course, Levy reports. Moreover, there was an OS benefit associated with NGS testing over non-NGS testing options, he states.

Multivariate models with treatment included in the study also indicated that patients who underwent NGS were more likely to receive an appropriate targeted therapy, which may explain the correlation between OS prolongation and NGS, Levy adds. Overall, these findings confirm the importance of utilizing contemporary strategies like NGS testing for molecular characterization in NSCLC, Levy concludes.

Disclosures: Dr Levy reports serving as a consultant or in an advisory role for Amgen, AstraZeneca, Daiichi Sankyo/Astra Zeneca, Genentech/Roche, Guardant Health, Janssen Oncology, Lilly, Merck, Mirati Therapeutics, Novartis, Pfizer, Sanofi, and Takeda; he received institutional research funding from AstraZeneca, Bristol-Myers Squibb, Genentech/Roche, Loxo, Merck, and Turning Point Therapeutics.