OBJECTIVES: This study describes patient characteristics, treatment patterns, and factors associated with biomarker testing in real-world US patients with advanced non-small cell lung cancer (aNSCLC).

METHODS: This retrospective cohort study of aNSCLC patients used the TEMPUS CancerLinQ oncology dataset. Patients diagnosed with stage IIIB/IV NSCLC (index date) between 1/1/2012 and 12/31/2020 and >18 years of age at index were included. Patient demographic and clinical characteristics were evaluated as potential predictors of biomarker testing (i.e. EGFR, KRAS, ALK, ROS1, BRAF, NTRK, MET, RET, or PD-L1) after aNSCLC diagnosis using logistic regression.

RESULTS: 6,877 patients met study criteria: 46.1% were female, median age (IQR) was 65.2 years (58.5–72.7), 73.1% were white, and 90.5% were diagnosed at stage IV. 41.7% (n=) patients received biomarker testing. 63.6% (n=4,377) received first-line (1L) treatment and 63.3% (n=2,771) and 24.8% (n=1,085) of those patients received 2L and 3L therapy, respectively. 1L treatment included chemotherapy (69.8%), chemotherapy + immune checkpoint inhibitor (ICI) (11.0%), ICI monotherapy (10.1%), tyrosine kinase inhibitors (7.9%), and other treatments (1.2%). Men (versus women; OR: 0.82, 95% CI: 0.74, 0.91), Black patients (versus White; OR: 0.83; 95% CI: 0.72, 0.97), patients with squamous (OR: 0.22, 95% CI: 0.19, 0.25) or unknown histology (OR: 0.53, 95% CI: 0.45, 0.61) (versus non-squamous histology), and patients with an ECOG of 2+ (OR: 0.69; 95% CI: 0.57, 0.84) or missing (OR: 0.56, 95% CI: 0.48, 0.66) (versus ECOG of 0) were less likely to undergo biomarker testing. Never smokers (versus current smokers; OR: 2.64; 95% CI: 2.05, 3.42), and patients diagnosed after 2015 (versus 2012) were more likely to undergo biomarker testing.

CONCLUSIONS: Despite the increase in targeted therapies for aNSCLC and ease of biomarker testing, many real-world aNSCLC patients were untested. Specifically, men, Black patients, current smokers, and patients with ECOG of 2+ were less likely to be tested.