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Real-World Outcomes of Companion Diagnostic Testing in Advanced NSCLC

A new study published in The Oncologist (online July 6, 2020; doi:10.1634/theoncologist.2019-0864) demonstrated the clinical utility of companion diagnostic testing as a first step in treating non-squamous advanced non-small cell lung cancer (NSCLC) in real-world clinical practice.

Companion diagnostic testing is used to identify patients with a high likelihood of benefiting from biomarker-driven treatments for advanced NSCLC.

Ani John, BSN, MPH, PhD, Roche Diagnostics (Pleasanton, CA), and colleagues attempted to better understand real-world outcomes of companion diagnostics to determine the value of precision medicine in advanced NSCLC. A total of 17,555 patients with non-squamous disease who were diagnosed between January 2011 and May 2018 were identified from the Flatiron Health database. Outcomes of those who had companion diagnostic testing (n = 14,732) were compared with those of patients who had no reported evidence of testing (n = 2823).

Researchers evaluated the association between companion diagnostic testing and overall survival through unadjusted and adjusted Cox proportional hazard regression models.

The mean age of patients in the sample was 67.2 years, researchers noted, adding that 91.7% were insured and 67.1% were white. Asian patients and those who were never-smokers were more likely to undergo companion diagnostic testing.

Dr John and colleagues found that patients with companion diagnostic testing lived longer than those without testing (13.04 vs 6.01 months, respectively) and had a decreased mortality risk (adjusted HR, 0.72; 95% CI, 0.69-0.76).

Additionally, they reported that a survival advantage was observed for patients with companion diagnostic testing who received biomarker-driven first-line therapy.

In their concluding remarks, authors of the study wrote that, “Patients with non-squamous advanced NSCLC who had companion diagnostic testing had a greater survival benefit than those without, supporting broader use of companion diagnostic testing in routine clinical practice to identify patients more likely to benefit from precision medicine.”—Zachary Bessette

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