Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study
Background: non-small cell lung cancer (NSCLC) outcomes remain suboptimal for early-stage disease despite emerging advances in systemic therapy for the peri-operative period. Next-generation sequencing (NGS) identifies driver mutations for which targeted therapies have been developed that improve su...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/30/1/12 |
| _version_ | 1797444039486734336 |
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| author | Roy Avraham Hilzenrat Stephen Yip Barbara Melosky Cheryl Ho Janessa Laskin Sophie Sun James J. Choi Anna L. McGuire |
| author_facet | Roy Avraham Hilzenrat Stephen Yip Barbara Melosky Cheryl Ho Janessa Laskin Sophie Sun James J. Choi Anna L. McGuire |
| author_sort | Roy Avraham Hilzenrat |
| collection | DOAJ |
| description | Background: non-small cell lung cancer (NSCLC) outcomes remain suboptimal for early-stage disease despite emerging advances in systemic therapy for the peri-operative period. Next-generation sequencing (NGS) identifies driver mutations for which targeted therapies have been developed that improve survival. The BC lung cancer screening program, which was initiated in May 2022, is expected to identify people with early and late stages of NSCLC. It is crucial to first understand the molecular epidemiology and patterns of time to initiate treatment across its five health authorities (HA) to optimize the delivery of care for NSCLC in BC. In this way, we may harness the benefits of targeted therapy for more people with NSCLC as novel advances in therapy continue to emerge. Objective: to compare (a) the frequency of actionable NSCLC molecular alterations among HAs and (b) the time to treatment initiation. Methods: a retrospective observational study was conducted with prospectively collected data from the BC CGL Database. Adults with late stage NSCLC who underwent targeted NGS were included for the time period from May 2020 to June 2021. Demographics, actionable molecular alterations, PDL-1 expression, and time to treatment across HAs were examined. Using appropriate statistical tests for comparison among HAs, p>0.05 was deemed significant. Results: 582 patients underwent NGS/IHC and analysis during the study period. The mean age was 71 (10.1), and 326 (56%) patients were female. A significantly higher proportion of all EGFRm+ were identified within Vancouver Coastal Health (VCHA) and Fraser Health Authority (FHA) compared to the other health authorities (<i>p</i> < 0.001). This also holds true for common sensitizing EGFRm+ alone (<i>p</i> < 0.001) and for sensitizing EGFRm+ when adjusted for females and smoker status (OR 0.75; 95% CI 0.62, 0.92; <i>p</i> = 0.005). Patients residing within the Northern, Interior, and Island HAs were less likely to receive treatment at the same rate as those in VCHA and FHA HAs. Conclusion: actionable NSCLC driver mutations are present in all regional HAs, with disparity noted in time to initiate treatment between HAs. This provides evidence for the importance of molecular testing for patients in all BC HAs to guide personalized and timely NSCLC treatment. |
| first_indexed | 2024-03-09T13:05:48Z |
| format | Article |
| id | doaj.art-8ccd2340e8eb457fabd5869d46aa4e27 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T13:05:48Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-8ccd2340e8eb457fabd5869d46aa4e272023-11-30T21:48:57ZengMDPI AGCurrent Oncology1198-00521718-77292022-12-0130114515610.3390/curroncol30010012Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort StudyRoy Avraham Hilzenrat0Stephen Yip1Barbara Melosky2Cheryl Ho3Janessa Laskin4Sophie Sun5James J. Choi6Anna L. McGuire7Department of Surgery, Division of Thoracic Surgery, Vancouver Coastal Health, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, CanadaCancer Genetics & Genomic Laboratory, BC Cancer—Vancouver Centre, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, CanadaDepartment of Medicine, Division of Medical Oncology, BC Cancer Vancouver Centre, University of British Columbia, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, CanadaDepartment of Medicine, Division of Medical Oncology, BC Cancer Vancouver Centre, University of British Columbia, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, CanadaDepartment of Medicine, Division of Medical Oncology, BC Cancer Vancouver Centre, University of British Columbia, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, CanadaDepartment of Medicine, Division of Medical Oncology, BC Cancer Vancouver Centre, University of British Columbia, 600 West 10th Avenue, Vancouver, BC V5Z 4E6, CanadaDepartment of Surgery, Division of Thoracic Surgery, Vancouver Coastal Health, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, CanadaDepartment of Surgery, Division of Thoracic Surgery, Vancouver Coastal Health, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, CanadaBackground: non-small cell lung cancer (NSCLC) outcomes remain suboptimal for early-stage disease despite emerging advances in systemic therapy for the peri-operative period. Next-generation sequencing (NGS) identifies driver mutations for which targeted therapies have been developed that improve survival. The BC lung cancer screening program, which was initiated in May 2022, is expected to identify people with early and late stages of NSCLC. It is crucial to first understand the molecular epidemiology and patterns of time to initiate treatment across its five health authorities (HA) to optimize the delivery of care for NSCLC in BC. In this way, we may harness the benefits of targeted therapy for more people with NSCLC as novel advances in therapy continue to emerge. Objective: to compare (a) the frequency of actionable NSCLC molecular alterations among HAs and (b) the time to treatment initiation. Methods: a retrospective observational study was conducted with prospectively collected data from the BC CGL Database. Adults with late stage NSCLC who underwent targeted NGS were included for the time period from May 2020 to June 2021. Demographics, actionable molecular alterations, PDL-1 expression, and time to treatment across HAs were examined. Using appropriate statistical tests for comparison among HAs, p>0.05 was deemed significant. Results: 582 patients underwent NGS/IHC and analysis during the study period. The mean age was 71 (10.1), and 326 (56%) patients were female. A significantly higher proportion of all EGFRm+ were identified within Vancouver Coastal Health (VCHA) and Fraser Health Authority (FHA) compared to the other health authorities (<i>p</i> < 0.001). This also holds true for common sensitizing EGFRm+ alone (<i>p</i> < 0.001) and for sensitizing EGFRm+ when adjusted for females and smoker status (OR 0.75; 95% CI 0.62, 0.92; <i>p</i> = 0.005). Patients residing within the Northern, Interior, and Island HAs were less likely to receive treatment at the same rate as those in VCHA and FHA HAs. Conclusion: actionable NSCLC driver mutations are present in all regional HAs, with disparity noted in time to initiate treatment between HAs. This provides evidence for the importance of molecular testing for patients in all BC HAs to guide personalized and timely NSCLC treatment.https://www.mdpi.com/1718-7729/30/1/12non-small cell lung cancerthoracic malignancycancer caredriver mutationsBritish Columbia |
| spellingShingle | Roy Avraham Hilzenrat Stephen Yip Barbara Melosky Cheryl Ho Janessa Laskin Sophie Sun James J. Choi Anna L. McGuire Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study Current Oncology non-small cell lung cancer thoracic malignancy cancer care driver mutations British Columbia |
| title | Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study |
| title_full | Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study |
| title_fullStr | Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study |
| title_full_unstemmed | Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study |
| title_short | Disparate Time-to-Treatment and Varied Incidence of Actionable Non-Small Cell Lung Cancer Molecular Alterations in British Columbia: A Historical Cohort Study |
| title_sort | disparate time to treatment and varied incidence of actionable non small cell lung cancer molecular alterations in british columbia a historical cohort study |
| topic | non-small cell lung cancer thoracic malignancy cancer care driver mutations British Columbia |
| url | https://www.mdpi.com/1718-7729/30/1/12 |
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