Top

Open Access 16-05-2024 | Lung Cancer | REVIEW

Healthcare disparities, screening, and molecular testing in the changing landscape of non–small cell lung cancer in the United States: a review

Authors: Razelle Kurzrock, Aadel A. Chaudhuri, David Feller-Kopman, Narjust Florez, Jed Gorden, Ignacio I. Wistuba

Published in: Cancer and Metastasis Reviews

Abstract

Inequitable access to care continues to hinder improvements in diagnosis and treatment of lung cancer. This review describes healthcare disparities in the changing landscape of non–small cell lung cancer (NSCLC) in the United States, focusing on racial, ethnic, sex-based, and socioeconomic trends. Furthermore, strategies to address disparities, overcome challenges, and improve patient outcomes are proposed. Barriers exist across lung cancer screening, diagnosis, and treatment regimens, varying by sex, age, race and ethnicity, geography, and socioeconomic status. Incidence and mortality rates of lung cancer are higher among Black men than White men, and incidences in young women are substantially greater than in young men. Disparities may be attributed to geographic differences in screening access, with correlating higher incidence and mortality rates in rural versus urban areas. Lower socioeconomic status is also linked to lower survival rates. Several strategies could help reduce disparities and improve outcomes. Current guidelines could improve screening eligibility by incorporating sex, race, and socioeconomic status variables. Patient and clinician education on screening guidelines and patient-level barriers to care are key, and biomarker testing is critical since ~ 70% of patients with NSCLC have an actionable biomarker. Timely diagnosis, staging, and comprehensive biomarker testing, including cell-free DNA liquid biopsy, may provide valuable treatment guidance for patients with NSCLC. Efforts to improve lung cancer screening and biomarker testing access, decrease bias, and improve education about screening and testing are needed to reduce healthcare disparities in NSCLC.

Siegel, R. L., Miller, K. D., Wagle, N. S., & Jemal, A. (2023). Cancer statistics, 2023. CA: A Cancer Journal for Clinicians, 73(1), 17–48. https://doi.org/10.3322/caac.21763CrossRefPubMed

American Cancer Society Inc. (2023). Cancer facts and figures. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/2023-cancer-facts-figures.html. Accessed 13 Jul 2023

Araghi, M., Mannani, R., Heidarnejad Maleki, A., Hamidi, A., Rostami, S., Safa, S. H., et al. (2023). Recent advances in non-small cell lung cancer targeted therapy. An update review. Cancer Cell International, 23(1), 162. https://doi.org/10.1186/s12935-023-02990-yCrossRefPubMed

Howlader, N., Forjaz, G., Mooradian, M. J., Meza, R., Kong, C. Y., Cronin, K. A., et al. (2020). The effect of advances in lung-cancer treatment on population mortality. New England Journal of Medicine, 383(7), 640–649. https://doi.org/10.1056/NEJMoa1916623CrossRefPubMed

National Cancer Institute. (2023). Cancer stat facts: Lung and bronchus cancer. https://seer.cancer.gov/statfacts/html/lungb.html. Accessed 13 Jul 2023

Aberle, D. R., Adams, A. M., Berg, C. D., Black, W. C., Clapp, J. D., Fagerstrom, R. M., et al. (2011). Reduced lung-cancer mortality with low-dose computed tomographic screening. New England Journal of Medicine, 365(5), 395–409. https://doi.org/10.1056/NEJMoa1102873CrossRefPubMed

Krist, A. H., Davidson, K. W., Mangione, C. M., Barry, M. J., Cabana, M., Caughey, A. B., et al. (2021). Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA, 325(10), 962–970. https://doi.org/10.1001/jama.2021.1117CrossRefPubMed

Haddad, D. N., Sandler, K. L., Henderson, L. M., Rivera, M. P., & Aldrich, M. C. (2020). Disparities in lung cancer screening: A review. Annals of the American Thoracic Society, 17(4), 399–405. https://doi.org/10.1513/AnnalsATS.201907-556CMECrossRefPubMedPubMedCentral

Arrazola, R. A., Griffin, T., Lunsford, N. B., Kittner, D., Bammeke, P., Courtney-Long, E. A., et al. (2023). US cigarette smoking disparities by race and ethnicity - Keep going and going! Preventing Chronic Disease, 20, E45. https://doi.org/10.5888/pcd20.220375CrossRefPubMedPubMedCentral

10.

Murphy, S. E., Park, S. L., Balbo, S., Haiman, C. A., Hatsukami, D. K., Patel, Y., et al. (2018). Tobacco biomarkers and genetic/epigenetic analysis to investigate ethnic/racial differences in lung cancer risk among smokers. NPJ Precision Oncology, 2, 17. https://doi.org/10.1038/s41698-018-0057-yCrossRefPubMedPubMedCentral

11.

Stram, D. O., Park, S. L., Haiman, C. A., Murphy, S. E., Patel, Y., Hecht, S. S., et al. (2019). Racial/ethnic differences in lung cancer incidence in the multiethnic cohort study: An update. Journal of the National Cancer Institute, 111(8), 811–819. https://doi.org/10.1093/jnci/djy206CrossRefPubMedPubMedCentral

12.

Giovino, G. A., Villanti, A. C., Mowery, P. D., Sevilimedu, V., Niaura, R. S., Vallone, D. M., et al. (2015). Differential trends in cigarette smoking in the USA: Is menthol slowing progress? Tobacco Control, 24(1), 28–37. https://doi.org/10.1136/tobaccocontrol-2013-051159CrossRefPubMed

13.

Arauz, R. F., Mayer, M., Reyes-Guzman, C., & Ryan, B. M. (2022). Racial disparities in cigarette smoking behaviors and differences stratified by metropolitan area of residence. International Journal of Public Health, 19(5). https://doi.org/10.3390/ijerph19052910

14.

Furlow, B. (2023). US Government finally moves to ban menthol cigarettes. The Lancet Respiratory Medicine, 11(12), 1048–1049. https://doi.org/10.1016/s2213-2600(23)00413-7CrossRefPubMed

15.

Baiu, I., Titan, A. L., Martin, L. W., Wolf, A., & Backhus, L. (2021). The role of gender in non-small cell lung cancer: A narrative review. Journal of Thoracic Disease, 13(6), 3816–3826. https://doi.org/10.21037/jtd-20-3128CrossRefPubMedPubMedCentral

16.

Clément-Duchêne, C., Stock, S., Xu, X., Chang, E. T., Gomez, S. L., West, D. W., et al. (2016). Survival among never-smokers with lung cancer in the cancer care outcomes research and surveillance study. Annals of the American Thoracic Society, 13(1), 58–66. https://doi.org/10.1513/AnnalsATS.201504-241OCCrossRefPubMedPubMedCentral

17.

Al Omari, O., Jani, C., Ahmed, A., Singh, H., Radwan, A., Bhatt, P., et al. (2023). Lung cancer mortality in the United States between 1999 and 2019: An observational analysis of disparities by sex and race. Annals of the American Thoracic Society, 20(4), 612–616. https://doi.org/10.1513/AnnalsATS.202206-510RLCrossRefPubMedPubMedCentral

18.

Carrot-Zhang, J., Soca-Chafre, G., Patterson, N., Thorner, A. R., Nag, A., Watson, J., et al. (2021). Genetic ancestry contributes to somatic mutations in lung cancers from admixed Latin American populations. Cancer Discovery, 11(3), 591–598. https://doi.org/10.1158/2159-8290.Cd-20-1165CrossRefPubMed

19.

Midha, A., Dearden, S., & McCormack, R. (2015). EGFR mutation incidence in non-small-cell lung cancer of adenocarcinoma histology: A systematic review and global map by ethnicity (mutMapII). American Journal of Cancer Research, 5(9), 2892–2911. www.ajcr.us

20.

DeRouen, M. C., Canchola, A. J., Thompson, C. A., Jin, A., Nie, S., Wong, C., et al. (2022). Incidence of lung cancer among never-smoking Asian American, Native Hawaiian, and Pacific Islander Females. Journal of the National Cancer Institute, 114(1), 78–86. https://doi.org/10.1093/jnci/djab143CrossRefPubMed

21.

Viñal, D., Martínez, D., Higuera, O., & de Castro, J. (2021). Genomic profiling in non-small-cell lung cancer in young patients. A systematic review. ESMO Open, 6(1), 100045. https://doi.org/10.1016/j.esmoop.2020.100045CrossRefPubMedPubMedCentral

22.

Jemal, A., Miller, K. D., Ma, J., Siegel, R. L., Fedewa, S. A., Islami, F., et al. (2018). Higher lung cancer incidence in young women than young men in the United States. New England Journal of Medicine, 378(21), 1999–2009. https://doi.org/10.1056/NEJMoa1715907CrossRefPubMed

23.

Centers for Disease Control and Prevention. (2022). United states cancer statistics: Data visualizations. https://gis.cdc.gov/Cancer/USCS/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcancer%2Fdataviz%2Findex.htm#/NationalPrevalence/. Accessed 28 Jul 2023

24.

National Cancer Institute. (2023). Cancer stat facts: Cancer among adolescents and young adults (AYAs) (Ages 15–39): New Cases and Deaths 2023. https://seer.cancer.gov/statfacts/html/aya.html. Accessed 13 Jul 2023

25.

Oliveira, I., Mota, P., & Almodovar, T. (2022). Lung cancer in young patients: Natural history, biology and prognosis. Pulmonology, 28(1), 80–81. https://doi.org/10.1016/j.pulmoe.2021.08.010CrossRefPubMed

26.

Arnold, B. N., Thomas, D. C., Rosen, J. E., Salazar, M. C., Blasberg, J. D., Boffa, D. J., et al. (2016). Lung cancer in the very young: Treatment and survival in the national cancer data base. Journal of Thoracic Oncology, 11(7), 1121–1131. https://doi.org/10.1016/j.jtho.2016.03.023CrossRefPubMed

27.

Cornelius, M. E., Loretan, C. G., Wang, T. W., Jamal, A., & Homa, D. M. (2022). Tobacco product use among adults - United States, 2020. Morbidity and Mortality Weekly Report, 71(11), 397–405. https://doi.org/10.15585/mmwr.mm7111a1CrossRefPubMedPubMedCentral

28.

Sahar, L., Douangchai Wills, V. L., Liu, K. K. A., Fedewa, S. A., Rosenthal, L., Kazerooni, E. A., et al. (2022). Geographic access to lung cancer screening among eligible adults living in rural and urban environments in the United States. Cancer, 128(8), 1584–1594. https://doi.org/10.1002/cncr.33996CrossRefPubMed

29.

Kish, J. K., Yu, M., Percy-Laurry, A., & Altekruse, S. F. (2014). Racial and ethnic disparities in cancer survival by neighborhood socioeconomic status in Surveillance, Epidemiology, and End Results (SEER) Registries. Journal of the National Cancer Institute Monographs, 2014(49), 236–243. https://doi.org/10.1093/jncimonographs/lgu020CrossRefPubMedPubMedCentral

30.

Morris, B. B., Hughes, R., Fields, E. C., Sabo, R. T., Weaver, K. E., & Fuemmeler, B. F. (2023). Sociodemographic and clinical factors associated with radiation treatment nonadherence and survival among rural and nonrural patients with cancer. International Journal of Radiation Oncology Biology Physics, 116(1), 28–38. https://doi.org/10.1016/j.ijrobp.2022.06.075CrossRefPubMed

31.

Sosa, E., D’Souza, G., Akhtar, A., Sur, M., Love, K., Duffels, J., et al. (2021). Racial and socioeconomic disparities in lung cancer screening in the United States: A systematic review. CA: A Cancer Journal for Clinicians, 71(4), 299–314. https://doi.org/10.3322/caac.21671CrossRefPubMed

32.

Jones, G. S., & Baldwin, D. R. (2018). Recent advances in the management of lung cancer. Clinical Medicine (London, England), 18(Suppl 2), s41–s46. https://doi.org/10.7861/clinmedicine.18-2-s41CrossRefPubMed

33.

de Koning, H. J., van der Aalst, C. M., de Jong, P. A., Scholten, E. T., Nackaerts, K., Heuvelmans, M. A., et al. (2020). Reduced lung-cancer mortality with volume CT screening in a randomized trial. New England Journal of Medicine, 382(6), 503–513. https://doi.org/10.1056/NEJMoa1911793CrossRefPubMed

34.

Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Lung Cancer Screening V.2.2024. ©National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed [January 04, 2024]. To view the most recent and complete version of the guideline, go to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. NCCN, National Comprehensive Cancer Network^® (NCCN^®).

35.

Fedewa, S. A., Bandi, P., Smith, R. A., Silvestri, G. A., & Jemal, A. (2022). Lung cancer screening rates during the COVID-19 pandemic. Chest, 161(2), 586–589. https://doi.org/10.1016/j.chest.2021.07.030CrossRefPubMed

36.

Niranjan, S. J., Opoku-Agyeman, W., Carroll, N. W., Dorsey, A., Tipre, M., Baskin, M. L., et al. (2021). Distribution and geographic accessibility of lung cancer screening centers in the United States. Annals of the American Thoracic Society, 18(9), 1577–1580. https://doi.org/10.1513/AnnalsATS.202010-1313RLCrossRefPubMedPubMedCentral

37.

Zgodic, A., Zahnd, W. E., Advani, S., & Eberth, J. M. (2022). Low-dose CT lung cancer screening uptake: A rural-urban comparison. The Journal of Rural Health, 38(1), 40–53. https://doi.org/10.1111/jrh.12568CrossRefPubMed

38.

Zarinshenas, R., Amini, A., Mambetsariev, I., Abuali, T., Fricke, J., Ladbury, C., et al. (2023). Assessment of barriers and challenges to screening, diagnosis, and biomarker testing in early-stage lung cancer. Cancers (Basel), 15(5). https://doi.org/10.3390/cancers15051595

39.

US Census Bureau. (2020). 2020 census demographic data map viewer. https://www.census.gov/library/visualizations/2021/geo/demographicmapviewer.html. Accessed 20 July 2023

40.

Narayan, A. K., Chowdhry, D. N., Fintelmann, F. J., Little, B. P., Shepard, J. O., & Flores, E. J. (2021). Racial and ethnic disparities in lung cancer screening eligibility. Radiology, 301(3), 712–720. https://doi.org/10.1148/radiol.2021204691CrossRefPubMed

41.

Harrison, S., Judd, J., Chin, S., & Ragin, C. (2022). Disparities in lung cancer treatment. Current Oncology Reports, 24(2), 241–248. https://doi.org/10.1007/s11912-022-01193-4CrossRefPubMedPubMedCentral

42.

Japuntich, S. J., Krieger, N. H., Salvas, A. L., & Carey, M. P. (2018). Racial disparities in lung cancer screening: An exploratory investigation. Journal of the National Medical Association, 110(5), 424–427. https://doi.org/10.1016/j.jnma.2017.09.003CrossRefPubMed

43.

Aldrich, M. C., Mercaldo, S. F., Sandler, K. L., Blot, W. J., Grogan, E. L., & Blume, J. D. (2019). Evaluation of USPSTF lung cancer screening guidelines among African American adult smokers. JAMA Oncology, 5(9), 1318–1324. https://doi.org/10.1001/jamaoncol.2019.1402CrossRefPubMedPubMedCentral

44.

Tanner, N. T., Gebregziabher, M., Hughes Halbert, C., Payne, E., Egede, L. E., & Silvestri, G. A. (2015). Racial differences in outcomes within the National Lung Screening Trial. Implications for widespread implementation. American Journal of Respiratory and Critical Care Medicine, 192(2), 200–208. https://doi.org/10.1164/rccm.201502-0259OCCrossRefPubMed

45.

Kligerman, S., & White, C. (2011). Epidemiology of lung cancer in women: Risk factors, survival, and screening. AJR. American Journal of Roentgenology, 196(2), 287–295. https://doi.org/10.2214/ajr.10.5412CrossRefPubMed

46.

Duma, N. (2020). Lung-cancer researchers and clinicians must pay more attention to women. Nature, 587(7834), S13. https://doi.org/10.1038/d41586-020-03151-1CrossRefPubMed

47.

Ragavan, M., & Patel, M. I. (2022). The evolving landscape of sex-based differences in lung cancer: A distinct disease in women. European Respiratory Review, 31(163). https://doi.org/10.1183/16000617.0100-2021

48.

Reese, T. J., Schlechter, C. R., Potter, L. N., Kawamoto, K., Del Fiol, G., Lam, C. Y., et al. (2021). Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations. JAMA Network Open, 4(1), e2033769. https://doi.org/10.1001/jamanetworkopen.2020.33769CrossRefPubMedPubMedCentral

49.

Rivera, M. P., Katki, H. A., Tanner, N. T., Triplette, M., Sakoda, L. C., Wiener, R. S., et al. (2020). Addressing disparities in lung cancer screening eligibility and healthcare access. An official American Thoracic Society statement. American Journal of Respiratory and Critical Care Medicine, 202(7), e95–e112. https://doi.org/10.1164/rccm.202008-3053STCrossRefPubMedPubMedCentral

50.

Steiling, K., Kathuria, H., Echieh, C. P., Ost, D. E., Rivera, M. P., Begnaud, A., et al. (2023). Research priorities for interventions to address health disparities in lung nodule management: An official American Thoracic Society research statement. American Journal of Respiratory and Critical Care Medicine, 207(6), e31–e46. https://doi.org/10.1164/rccm.202212-2216STCrossRefPubMedPubMedCentral

51.

Borondy Kitts, A. K. (2019). The patient perspective on lung cancer screening and health disparities. Journal of the American College of Radiology, 16(4 Pt B), 601–606. https://doi.org/10.1016/j.jacr.2018.12.028CrossRefPubMed

52.

Deppen, S. A., Grogan, E. L., Aldrich, M. C., & Massion, P. P. (2014). Lung cancer screening and smoking cessation: A teachable moment? Journal of the National Cancer Institute, 106(6), dju122. https://doi.org/10.1093/jnci/dju122CrossRefPubMedPubMedCentral

53.

Sands, J., Tammemägi, M. C., Couraud, S., Baldwin, D. R., Borondy-Kitts, A., Yankelevitz, D., et al. (2021). Lung screening benefits and challenges: A review of the data and outline for implementation. Journal of Thoracic Oncology, 16(1), 37–53. https://doi.org/10.1016/j.jtho.2020.10.127CrossRefPubMed

54.

Wiener, R. S., & Gould, M. K. (2023). Selecting candidates for lung cancer screening: Implications for effectiveness, efficiency, equity, and implementation. Annals of Internal Medicine, 176(3), 413–414. https://doi.org/10.7326/m23-0230CrossRefPubMed

55.

Mazzone, P. J., Silvestri, G. A., Souter, L. H., Caverly, T. J., Kanne, J. P., Katki, H. A., et al. (2021). Screening for lung cancer: CHEST guideline and expert panel report. Chest, 160(5), e427–e494. https://doi.org/10.1016/j.chest.2021.06.063CrossRefPubMedPubMedCentral

56.

van Os, S., Syversen, A., Whitaker, K. L., Quaife, S. L., Janes, S. M., Jallow, M., et al. (2022). Lung cancer symptom appraisal, help-seeking and diagnosis - Rapid systematic review of differences between patients with and without a smoking history. Psycho-Oncology, 31(4), 562–576. https://doi.org/10.1002/pon.5846CrossRefPubMed

57.

Healthcare Safety Investigation Branch. (2022). Missed detection of lung cancer on chest X-rays of patients being seen in primary care. https://www.hssib.org.uk/patient-safety-investigations/missed-detection-of-lung-cancer-on-chest-x-rays-of-patients-being-seen-in-primary-care/investigation-report/. Accessed 13 Jul 2023

58.

Singh, N., Aggarwal, A. N., Gupta, D., Behera, D., & Jindal, S. K. (2012). Quantified smoking status and non-small cell lung cancer stage at presentation: Analysis of a North Indian cohort and a systematic review of literature. Journal of Thoracic Disease, 4(5), 474–484. https://doi.org/10.3978/j.issn.2072-1439.2012.05.11CrossRefPubMedPubMedCentral

59.

Hung, H. Y., Tseng, Y. H., Chao, H. S., Chiu, C. H., Hsu, W. H., Hsu, H. S., et al. (2020). Multidisciplinary team discussion results in survival benefit for patients with stage III non-small-cell lung cancer. PLoS One, 15(10), e0236503. https://doi.org/10.1371/journal.pone.0236503CrossRefPubMedPubMedCentral

60.

Varma, T., Mello, M., Ross, J. S., Gross, C., & Miller, J. (2023). Metrics, baseline scores, and a tool to improve sponsor performance on clinical trial diversity: Retrospective cross sectional study. BMJ Medicine, 2(1), e000395. https://doi.org/10.1136/bmjmed-2022-000395CrossRefPubMedPubMedCentral

61.

Bodicoat, D. H., Routen, A. C., Willis, A., Ekezie, W., Gillies, C., Lawson, C., et al. (2021). Promoting inclusion in clinical trials-A rapid review of the literature and recommendations for action. Trials, 22(1), 880. https://doi.org/10.1186/s13063-021-05849-7CrossRefPubMedPubMedCentral

62.

Yusuf, R. A., Rogith, D., Hovick, S. R., Peterson, S. K., Burton-Chase, A. M., Fellman, B. M., et al. (2015). Attitudes toward molecular testing for personalized cancer therapy. Cancer, 121(2), 243–250. https://doi.org/10.1002/cncr.28966CrossRefPubMed

63.

Hofmarcher, T., Malmberg, C., & Lindgren, P. (2023). A global analysis of the value of precision medicine in oncology - The case of non-small cell lung cancer. Frontiers in Medicine (Lausanne), 10, 1119506. https://doi.org/10.3389/fmed.2023.1119506CrossRef

64.

Musika, W., Kamsa-Ard, S., Jirapornkul, C., Santong, C., & Phunmanee, A. (2021). Lung cancer survival with current therapies and new targeted treatments: A comprehensive update from the Srinagarind Hospital-Based Cancer Registry from (2013 to 2017). Asian Pacific Journal of Cancer Prevention, 22(8), 2501–2507. https://doi.org/10.31557/apjcp.2021.22.8.2501CrossRefPubMedPubMedCentral

65.

Hirsch, F. R., Scagliotti, G. V., Mulshine, J. L., Kwon, R., Curran, W. J., Jr., Wu, Y. L., et al. (2017). Lung cancer: Current therapies and new targeted treatments. Lancet, 389(10066), 299–311. https://doi.org/10.1016/s0140-6736(16)30958-8CrossRefPubMed

66.

Martin, C. (2021). Perceptions of biomarker testing for underserved patients with lung cancer: A mixed-methods survey of U.S.-based oncology clinicians. https://www.iaslc.org/iaslc-news/press-release/perceptions-biomarker-testing-underserved-patients-lung-cancer-mixed. Accessed 1 Nov 2023

67.

Vanderpoel, J., Stevens, A. L., Emond, B., Lafeuille, M. H., Hilts, A., Lefebvre, P., et al. (2022). Total cost of testing for genomic alterations associated with next-generation sequencing versus polymerase chain reaction testing strategies among patients with metastatic non-small cell lung cancer. Journal of Medical Economics, 25(1), 457–468. https://doi.org/10.1080/13696998.2022.2053403CrossRefPubMed

68.

Sadik, H., Pritchard, D., Keeling, D. M., Policht, F., Riccelli, P., Stone, G., et al. (2022). Impact of clinical practice gaps on the implementation of personalized medicine in advanced non–small-cell lung cancer. JCO Precision Oncology, 6, e2200246. https://doi.org/10.1200/po.22.00246CrossRefPubMedPubMedCentral

69.

Kalemkerian, G. P., Narula, N., Kennedy, E. B., Biermann, W. A., Donington, J., Leighl, N. B., et al. (2018). Molecular testing guideline for the selection of patients with lung cancer for treatment with targeted tyrosine kinase inhibitors: American Society of Clinical Oncology Endorsement of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology Clinical Practice Guideline Update. Journal of Clinical Oncology, 36(9), 911–919. https://doi.org/10.1200/jco.2017.76.7293CrossRefPubMed

70.

Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines^®) for Non-Small Cell Lung Cancer V.3.2024. ©National Comprehensive Cancer Network, Inc. 2024. All rights reserved. Accessed [March 20, 2024]. To view the most recent and complete version of the guideline, go to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. NCCN, National Comprehensive Cancer Network^® (NCCN^®).

71.

Villalobos, P., & Wistuba, I. I. (2017). Lung cancer biomarkers. Hematology/oncology Clinics of North America, 31(1), 13–29. https://doi.org/10.1016/j.hoc.2016.08.006CrossRefPubMedPubMedCentral

72.

Luchini, C., Bibeau, F., Ligtenberg, M. J. L., Singh, N., Nottegar, A., Bosse, T., et al. (2019). ESMO recommendations on microsatellite instability testing for immunotherapy in cancer, and its relationship with PD-1/PD-L1 expression and tumour mutational burden: A systematic review-based approach. Annals of Oncology, 30(8), 1232–1243. https://doi.org/10.1093/annonc/mdz116CrossRefPubMed

73.

Holmes, M., Mahar, A., Lum, T., Boyer, M., Kao, S., & Cooper, W. (2019). Prevalence of PD-L1 expression rates in different NSCLC specimens. Journal of Thoracic Oncology, 14(10_suppl), S506. Poster P1.09-26. https://doi.org/10.1016/j.jtho.2019.08.1055

74.

Kerr, K. M., Bibeau, F., Thunnissen, E., Botling, J., Ryška, A., Wolf, J., et al. (2021). The evolving landscape of biomarker testing for non-small cell lung cancer in Europe. Lung Cancer, 154, 161–175. https://doi.org/10.1016/j.lungcan.2021.02.026CrossRefPubMed

75.

US Food and Drug Administration. (2021). FDA approves pembrolizumab for adults and children with TMB-H solid tumors. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-pembrolizumab-adults-and-children-tmb-h-solid-tumors. Accessed 13 Jun 2023

76.

Farago, A. F., Taylor, M. S., Doebele, R. C., Zhu, V. W., Kummar, S., Spira, A. I. (2018). Clinicopathologic features of non-small-cell lung cancer harboring an NTRK gene fusion. JCO Precision Oncology, 2018 https://doi.org/10.1200/po.18.00037

77.

Rolfo, C., Mack, P., Scagliotti, G. V., Aggarwal, C., Arcila, M. E., Barlesi, F., et al. (2021). Liquid biopsy for advanced NSCLC: A consensus statement from the International Association for the Study of Lung Cancer. Journal of Thoracic Oncology, 16(10), 1647–1662. https://doi.org/10.1016/j.jtho.2021.06.017CrossRefPubMed

78.

US Food and Drug Administration. (2023). List of cleared or approved companion diagnostic devices (in vitro and imaging tools). https://www.fda.gov/medical-devices/in-vitro-diagnostics/list-cleared-or-approved-companion-diagnostic-devices-in-vitro-and-imaging-tools. Accessed 18 Jul 2023

79.

Odegaard, J. I., Vincent, J. J., Mortimer, S., Vowles, J. V., Ulrich, B. C., Banks, K. C., et al. (2018). Validation of a plasma-based comprehensive cancer genotyping assay utilizing orthogonal tissue- and plasma-based methodologies. Clinical Cancer Research, 24(15), 3539–3549. https://doi.org/10.1158/1078-0432.Ccr-17-3831CrossRefPubMed

80.

Leighl, N. B., Page, R. D., Raymond, V. M., Daniel, D. B., Divers, S. G., Reckamp, K. L., et al. (2019). Clinical utility of comprehensive cell-free DNA analysis to identify genomic biomarkers in patients with newly diagnosed metastatic non-small cell lung cancer. Clinical Cancer Research, 25(15), 4691–4700. https://doi.org/10.1158/1078-0432.Ccr-19-0624CrossRefPubMed

81.

Mack, P. C., Banks, K. C., Espenschied, C. R., Burich, R. A., Zill, O. A., Lee, C. E., et al. (2020). Spectrum of driver mutations and clinical impact of circulating tumor DNA analysis in non-small cell lung cancer: Analysis of over 8000 cases. Cancer, 126(14), 3219–3228. https://doi.org/10.1002/cncr.32876CrossRefPubMed

82.

Levy, B. P., Chioda, M. D., Herndon, D., Longshore, J. W., Mohamed, M., Ou, S. H., et al. (2015). Molecular testing for treatment of metastatic non-small cell lung cancer: How to implement evidence-based recommendations. The Oncologist, 20(10), 1175–1181. https://doi.org/10.1634/theoncologist.2015-0114CrossRefPubMedPubMedCentral

83.

Anand, K., Phung, T. L., Bernicker, E. H., Cagle, P. T., Olsen, R. J., & Thomas, J. S. (2020). Clinical utility of reflex ordered testing for molecular biomarkers in lung adenocarcinoma. Clinical Lung Cancer, 21(5), 437–442. https://doi.org/10.1016/j.cllc.2020.05.007CrossRefPubMed

84.

Slavik, T., Asselah, F., Fakhruddin, N., El Khodary, A., Torjman, F., Anis, E., et al. (2014). Diagnosis and predictive molecular analysis of non-small-cell lung cancer in the Africa-Middle East region: Challenges and strategies for improvement. Clinical Lung Cancer, 15(6), 398–404. https://doi.org/10.1016/j.cllc.2014.06.005CrossRefPubMed

85.

Boehmer, L., Roy, U., Schrag, J., Martin, N., Salinas, G., Coleman, B., et al. (2021). OA10.01 Perceptions of biomarker testing for underserved patients with lung cancer: A mixed-methods survey of US-based oncology clinicians. Journal of Thoracic Oncology, 16(10_suppl), S863–S864. https://doi.org/10.1016/j.jtho.2021.08.064CrossRef

86.

Zer, A., Cutz, J. C., Sekhon, H., Hwang, D. M., Sit, C., Maganti, M., et al. (2018). Translation of knowledge to practice-improving awareness in NSCLC molecular testing. Journal of Thoracic Oncology, 13(7), 1004–1011. https://doi.org/10.1016/j.jtho.2018.03.005CrossRefPubMed

87.

Hsiao, S. J., Sireci, A. N., Pendrick, D., Freeman, C., Fernandes, H., Schwartz, G. K., et al. (2020). Clinical utilization, utility, and reimbursement for expanded genomic panel testing in adult oncology. JCO Precision Oncology, 4, 1038–1048. https://doi.org/10.1200/po.20.00048CrossRefPubMed

88.

Desai, K., Hooker, G., Gilbert, K., Cropper, C., Metcalf, R., & Kachroo, S. (2021). Real-world trends in costs of next generation sequencing (NGS) testing in US setting. Journal of Clinical Oncology, 39(15_suppl), e18824–e18824. https://doi.org/10.1200/JCO.2021.39.15_suppl.e18824CrossRef

89.

Ray, T. (2017). CMS 14-day rule revisions ease precision medicine access for patients, stakeholders say. https://www.precisionmedicineonline.com/reimbursement/cms-14-day-rule-revisions-ease-precision-medicine-access-patients-stakeholders-say. Accessed 3 Jun 2023

90.

Centers for Medicare & Medicaid Services. (2018). Next Generation Sequencing (NGS) for Medicare beneficiaries with advanced cancer. https://www.cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?NCAId=296. Accessed 13 Jul 2023

Title: Healthcare disparities, screening, and molecular testing in the changing landscape of non–small cell lung cancer in the United States: a review
Authors: Razelle Kurzrock
Aadel A. Chaudhuri
David Feller-Kopman
Narjust Florez
Jed Gorden
Ignacio I. Wistuba
Publication date: 16-05-2024
Publisher: Springer US
Keywords: Lung Cancer
Lung Cancer
Lung Cancer
NSCLC
NSCLC
Biomarkers
Published in: Cancer and Metastasis Reviews
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI: https://doi.org/10.1007/s10555-024-10187-6

ERS Congress 2024

Springer Medicine

Healthcare disparities, screening, and molecular testing in the changing landscape of non–small cell lung cancer in the United States: a review

Abstract

ERS Congress 2024

Springer Medicine

Abstract

Please log in to get access to this content