Lugano, Switzerland, 23 March 2022 - More than half of patients diagnosed with advanced non-small cell lung cancer (NSCLC) undergo biomarker testing, and this figure has increased over the last five years, reveal real-world data from a Spanish national registry study reported at the European Lung Cancer Congress (ELCC), 30 March-2 April 2022. The results of this study illustrate the value of registry data for improving lung cancer care. (1)
“The overall survival of patients with lung cancer has increased by around 15% over the last decade, primarily because we now have new therapies, including targeted drugs. To use these therapies, we need to determine the molecular biomarkers on a patient’s tumour. Our study analysed the rate of this molecular testing in real-world clinical practice,” explained lead author Dr. Virginia Calvo de Juan, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain.
The study assessed biomarker testing in the Thoracic Tumours Registry, an observational, prospective registry in Spain that included data for 9239 patients diagnosed with stage IV NSCLC from 2016 to date. “Results showed that tumour biomarker testing was performed in 85% of patients with non-squamous tumours and 56.3% of those with squamous tumours, and that’s important for making treatment decisions,” reported Calvo de Juan. Nearly half (44.5%) of patients undergoing testing had a positive result for either EGFR, ALK, KRAS, BRAF, ROS1 or PDL-1.
The registry analysis showed a significant increase in all molecular testing over the last few years. “The key message is that it is very important to have a registry to collect information on real-life cancer care. We can’t do better if we don’t have a clear idea of what we are doing in routine clinical practice,” suggested Calvo de Juan. She noted that 182 hospitals across Spain participate in the Thoracic Tumours Registry.
“The Spanish Group is one of the best study groups in Europe and is very committed to providing targeted treatments to lung cancer patients,” commented Prof. Rolf Stahel, president of the European Thoracic Oncology Platform (ETOP). “Analysing the registry data shows a very high rate of molecular testing over a five-year period,” he said. He considered that it would be helpful to also look at how frequently molecular testing resulted in individual patients receiving appropriate targeted treatment.
“Cancer registries are very important in improving outcomes for cancer patients for several reasons,” explained Stahel. “First, they can be useful to improve the standard of patient care.” A population-based or hospital-based registry collects data on patients that can then be analysed for particular aspects of cancer diagnosis, treatment and outcomes. “You can then look at how a particular hospital or region is performing, benchmark against other populations and see where you stand and how you can improve. Second, cancer registries can provide a way of studying treatment effects in very rare cancers where there are too few patients to perform randomised trials.”
ESMO has collaborated with the International Agency for Research on Cancer (IARC) and institutions to build a population-based registry in lung cancer in Asian countries, including regions of Malaysia, Thailand, Indonesia, and a clinical registry in Singapore. The first question the registry analysed was the proportion of patients with a pathological diagnosis or a clinical diagnosis, before looking at molecular testing for available targeted drugs. “The results were very heterogenous between these countries,” Stahel noted. “The current step consists in identifying the gaps that lead to variations in care and how healthcare providers can be supported to address these gaps.” He concluded, “By supporting cancer registries we can help to support the dissemination of advances in cancer care across different regions to improve treatment and ensure that all patients can benefit.”
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(1) Abstract 39P ‘Determination of essential biomarkers in lung cancer: a real-world data study in Spain‘ will be available as ePoster as of Tuesday, 29 March 2022 at 12:00 CEST. Annals of Oncology, Volume 33 Supplement 2, April 2022
About the European Lung Cancer Congress
ELCC brings together some of the most important organisations in the field of thoracic oncology, with the scope of disseminating education through a multidisciplinary approach and improve the practice of lung cancer specialists worldwide. ELCC is organised by ESMO (European Society for Medical Oncology) and the IASLC (International Association for the Study of Lung Cancer), along with their partner societies ESTRO (European Society for Radiotherapy & Oncology), ESTS (European Society for Thoracic Surgeons) and ETOP IBCSG Partners Foundation (European Thoracic Oncology Platform and International Breast Cancer Study Group).
39P - Determination of essential biomarkers in lung cancer: a real-world data study in Spain.
V. Calvo de Juan1, M. Cobo Dols2, D. Rodriguez-Abreu3, E. Carcereny4, A. Cantero5, R. Bernabé Caro6, G. Benitez Lopez3, R. Lopez Castro7, B. Massuti Sureda8, E. del Barco9, M.R. Garcia Campelo10, M. Guirado11, C.J.C. Camps Herrero12, A.L.O. Ortega Granados13, J.L. Gonzalez-Larriba14, A. Sanchez Hernandez15, C. Gonzalez Ojea16, M.A. Sala Gonzalez17, O.J. Juan Vidal18, M. Provencio Pulla1
1Medical Oncology Department, University Hospital Puerta de Hierro Majadahonda, Majadahonda, Madrid, Spain, 2Medical Oncology, Biomedical Research Institute of Málaga (IBIMA), Malaga, Spain, 3Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas De Gran Canaria, Spain, 4National and Kapodistrian University & Frontier Science Foundation Hellas, Athens, Greece, 5Oncología Médica., Hospital Regional Universitario Málaga Carlos Haya, Malaga, Spain, 6Medical Oncology, Hospital Universitario Virgen del Rocio, Sevilla, Spain, 7Radiation And Medical Oncology Department, Hospital Clinico Universitario De Valladolid, Valladolid, Spain, 8Medical Oncology department, Hospital General Universitario de Alicante, Alicante, Spain, 9ONcology, HOSP. CLINICO UNIVERSITARIO SALAMANCA, Salamanca, Spain, 10Dept. Medical Oncology, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain, 11Hospital General Universitario de Elche, Elche, Alicante, Spain, 12Hospital General Universitario Valencia, Valencia, Spain, 13Medical Oncology Department, Hospital Universitario de Jaén, Jaén, Jaen, Spain, 14Medical Oncology department, Hospital Clinico Universitario San Carlos, Madrid, Spain, 15Medical Oncology Department, Consorcio Hospitalario Provincial de Castellón, Castellon De La Plana, Spain, 16Hospital Universitario Alvaro Cunqueiro, Vigo, Pontevedra, Spain, 17Hospital Universitario de Basurto, Bilbao, Spain, 18Medical Oncology Dept., Hospital Universitari i Politècnic La Fe, Valencia, Spain
Background: The Thoracic Tumours Registry (TTR) is an observational, prospective, registry-based study that included patients diagnosed with lung cancer and other thoracic tumours, from September 2016 to date. This TTR study was sponsored by the Spanish Lung Cancer Group (GECP) Foundation, an independent, scientific, multidisciplinary oncology society that coordinates more than 550 experts and 182 hospitals across the Spanish territory.
Methods: To study the situation of biomarker testing in Spain.
Results: 9,239 patients diagnosed with stage IV non-small cell lung cancer (NSCLC) were analysed. 7,467 (80.8%) were non-squamous and 1,772 (19.2%) were squamous. Tumour marker testing was performed in 85.0% of patients with non-squamous tumours vs 56.3% in those with squamous tumours (p-value <0.001). The global testing of EGFR, ALK, and ROS1 was 78.9%, 64.7%, 35.6% respectively, in non-squamous histology. PDL1 was determined globally in the same period (46.9%), although if we focus on the last 3 years it exceeds 85%. There has been a significant increase in the last few years of all determinations and there are even close to 10% of molecular determinations that do not yet have targeted drug approval but will have it in the near future. 4,115 cases had a positive result (44.5%) for either EGFR, ALK, KRAS, BRAF, ROS1, or PDL1.
Conclusions: Despite the lack of a national project and standard protocol in Spain that regulates the determination of biomarkers, the situation is similar to other European countries. Given the growing number of different determinations and their high positivity, national strategies are urgently needed to implement next-generation sequencing NGS in an integrated and cost-effective way in lung cancer.
Clinical trial identification: NCT02941458
Legal entity responsible for the study: FUNDACION GECP
Funding: Has not received any funding
Disclosure: All authors have declared no conflicts of interest.
Annals of Oncology