Optimising primary molecular profiling in non-small cell lung cancer
R. D. Schouten, I. Schouten, M. M. F. Schuurbiers, V. van der Noort, R. A. M. Damhuis, E. H. F. M. van der Heijden, J. A. Burgers, N. P. Barlo, A. S. R. van Lindert, K. W. Maas, J. J. G. van den Brand, A. A. J. Smit, J. M. W. van Haarst, B. van der Maat, E. Schuuring, H. Blaauwgeers, S. M. Willems, K. Monkhorst, D. van den Broek, M. M. van den Heuvel
Abstract
Molecular profiling of NSCLC is essential for optimising treatment decisions, but often incomplete. We assessed the efficacy of protocolised molecular profiling in the current standard-of-care (SoC) in a prospective observational study.
Introduction
Biomarker testing in patients with metastatic non-small cell lung cancer (NSCLC) is essential for making optimal treatment decisions [1–3]. There is an increasing number of targetable alterations for which tyrosine kinase inhibitors (TKIs) are available [4].
Material and Methods
In this multicentre prospective cohort study executed in ten hospitals across The Netherlands (S1 Table) patients with a suspicion of non-small cell lung cancer (NSCLC) or established NSCLC but still awaiting treatment were recruited.
Result
A total of 1108 patients were assessed for eligibility in ten participating hospitals in the Netherlands and 230 patients were excluded. During the run-in phase of the study, 136 patients were included.
Discussion
This study showed a significant increase in the rate of molecular profiling by protocolising diagnostic routines. Even in metastatic non-squamous NSCLC, where testing is strongly recommended by guidelines, the rate of profiling can be improved.
Conclusion
This study demonstrates comprehensive molecular profiling can be optimised by a protocolised approach. However, tissue-based profiling will remain unfeasible for a minority of patients.
Citation: Schouten RD, Schouten I, Schuurbiers MMF, van der Noort V, Damhuis RAM, van der Heijden EHFM, et al. (2024) Optimising primary molecular profiling in non-small cell lung cancer. PLoS ONE 19(7): e0290939. https://doi.org/10.1371/journal.pone.0290939
Editor: Tetsunari Hase, Nagoya University Graduate School of Medicine, JAPAN
Received: August 18, 2023; Accepted: May 2, 2024; Published: July 31, 2024
Copyright: © 2024 Schouten et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data are accessible through the Netherlands Cancer Institute Institutional Data Access for researchers who fulfill the eligibility criteria for accessing confidential data. The investigator site file (internal trial identification code: M15LEM) and all associated samples and data are securely maintained at the Netherlands Cancer Institute (NKI). For inquiries, researchers can contact the dedicated department for clinical trials at Trialbureau Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam (Tel: +31 20 512 9111; Email: communicatie@nki.nl).
Funding: This study was an investigator-initiated trial, designed by the authors and financially supported by unrestricted grants from Merck Sharp & Dohme (Kenilworth, New Jersey, USA), AstraZeneca (Cambridge, United Kingdom), Novartis (Basel, Switzerland), Pfizer (New York City, New York, USA) and Roche (Basel, Switzerland). The study sponsors approved the manuscript, but they had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation of the manuscript; and decision to submit the manuscript for publication. The authors received no personal funding for this work.
Competing interests: This study was an investigator-initiated trial, designed by the authors and financially supported by unrestricted grants from Merck Sharp & Dohme, AstraZeneca, Novartis, Pfizer, and Roche. These sponsors approved the manuscript but had no role in the study’s design, conduct, data collection, management, analysis, interpretation, manuscript preparation, or the decision to submit the manuscript for publication. The authors have declared the following potential conflicts of interest: Robert D. Schouten received research funding from AstraZeneca, Roche Pharma AG, Roche Diagnostics, MSD, Novartis, and Pfizer. J.A. Burgers received support for another investigator-initiated study from MSD and consulting fees from Roche. Ed Schuuring gave lectures for multiple companies, consulted in advisory boards for multiple companies, and received research grants from multiple companies. S.M. Willems received research funding from Lilly, Roche, Amgen, Pfizer, MSD, and Bayer. K. Monkhorst held a consulting or advisory role for multiple companies, was part of a speakers’ bureau for Quadia, received research funding from multiple companies, and had travel, accommodations, and expenses covered by Takeda. D. van den Broek held a consulting or advisory role for Roche Molecular Diagnostics. M.M. van den Heuvel held a consulting or advisory role for multiple companies, received research funding from multiple companies, and has patents, royalties, and other intellectual property from research funding by multiple companies. All other authors declared no conflicts of interest. None of the funding, support, or sponsoring described alters our adherence to PLOS ONE policies on sharing data and materials, and there are no restrictions on the sharing of data and/or materials.
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0290939#abstract0
