Office of Innovation & Research, Grand River Hospital, Kitchener, ON N2G 1G3, Canada.
Department of Oncology, London Health Sciences Centre, London, ON N6A 5W9, Canada.
Curr Oncol. 2024 Mar 14;31(3):1515-1528. doi: 10.3390/curroncol31030115.
: Timely reporting of molecular biomarkers is critical in guiding optimal treatment decisions in patients with advanced non-small cell lung carcinoma (NSCLC). Any delays along the tissue or treatment pathway may be associated with suboptimal treatment/outcomes and a reduced quality of life. For many centres, biomarkers are tested off-site. A retrospective chart review of 123 patients with advanced NSCLC seen between 1 June 2021 and 30 June 2022 was conducted. With a focus on core biomarkers (PD L1, EGFR, and ALK), the outcome variables were as follows: total turnaround time (total TAT), divided into pre-laboratory, laboratory, and post-laboratory time intervals, as well as time to treatment decision (TOTD) and time to optimal systemic therapy decision (TOTSD). At first consult, only 20.3% of patients had all core biomarker results available. The median total TAT was significantly longer for non-squamous (non-SCC) than squamous cell carcinoma (SCC) specimens (36.5 versus 22 days, < 0.001). The median pre-laboratory time for the entire cohort was 5 calendar days. The median laboratory testing time was greater for non-SCC compared to the SCC specimens (23 versus 12 days, < 0.001). The median time from consult to TOTD was 19 calendar days for the entire cohort. This study emphasizes the need for the expansion of regional resources to meet the clinical needs of advanced NSCLC patients treated at a regional cancer centre which uses an off-site molecular laboratory.
及时报告分子生物标志物对于指导晚期非小细胞肺癌（NSCLC）患者的最佳治疗决策至关重要。组织或治疗途径中的任何延迟都可能与治疗效果不佳和生活质量降低有关。对于许多中心来说，生物标志物是在外部进行测试的。对 2021 年 6 月 1 日至 2022 年 6 月 30 日期间就诊的 123 例晚期 NSCLC 患者进行了回顾性图表审查。重点关注核心生物标志物（PD-L1、EGFR 和 ALK），结果变量如下：总周转时间（总 TAT），分为实验室前、实验室和实验室后时间间隔，以及治疗决策时间（TOTD）和最佳系统治疗决策时间（TOTSD）。在首次就诊时，只有 20.3%的患者拥有所有核心生物标志物的结果。非鳞状细胞癌（非 SCC）标本的总 TAT 中位数明显长于鳞状细胞癌（SCC）标本（36.5 天与 22 天，<0.001）。整个队列的中位实验室前时间为 5 个日历日。非 SCC 标本的中位实验室检测时间明显长于 SCC 标本（23 天与 12 天，<0.001）。整个队列从咨询到 TOTD 的中位时间为 19 个日历日。本研究强调需要扩大区域资源，以满足在使用外部分子实验室的区域癌症中心治疗的晚期 NSCLC 患者的临床需求。
