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Interim Management Strategies Could Aid Patients With Advanced NSCLC Awaiting Biomarker Test Results

*November 2023*

Although biomarker testing is crucial for determining optimal targeted therapies for patients with advanced non–small cell lung cancer (NSCLC), the time between conducting these tests and receiving results poses challenges for both oncologists and patients, according to Stephen V. Liu, MD.

“There are cases where we need to act fairly quickly [if] someone is symptomatic, and [we] use symptoms and disease burden to guide that [decision],” Liu said in an interview with OncLive® during the 18th Annual New York Lung Cancers Symposium®.

In the interview, Liu shared his insights on optimal ways to care for patients with NSCLC who are awaiting biomarker test results, which he presented on at the meeting. He highlighted the importance of biomarker testing for identifying effective targeted therapies for patients with lung cancer, characteristics that would make patients ideal candidates for chemotherapy before they receive biomarker test results, and strategies for symptom management during the waiting period.

Liu is an associate professor of medicine of Georgetown University, as well as the director of Thoracic Oncology and head of Developmental Therapeutics at Georgetown Lombardi Comprehensive Cancer Center in Washington, DC.

OncLive: What is the importance of conducting biomarker testing for patients with advanced NSCLC and waiting for the results before selecting a treatment?

Liu: When we treat a patient with advanced NSCLC, we need biomarker results, but they’re not always available to us right away. We’ll get a diagnosis of lung cancer, but the next-generation sequencing may take a few weeks. What do we do in the meantime? It’s easy to say we just wait for those results, but the patients are often anxious to start therapy, which is understandable because the symptoms [they are experiencing have] probably been going on for a while. Additionally, there are often delays in diagnosis, [so patients have a] sense of urgency; they want to get started [on treatment] quickly.

However, we need to stress that we’re not looking for the fastest treatment; we’re looking for the right treatment. There are consequences with giving the wrong therapy or giving treatment in the wrong order. We know that when we give immunotherapy before a targeted agent, such as a TKI, it increases the toxicity of that TKI. We want to avoid putting ourselves and our patients in that situation. Read more.