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• W4387251657 abstract "SESSION TITLE: Late-Breaking Development in Lung Cancer, Lung Transplantation, and Pleural Disease SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/10/2023 12:00 pm - 12:50 pm PURPOSE: Despite advances in precision medicine for non-small cell lung cancer (NSCLC), biomarker testing to assess eligibility for these therapies remain frequently underutilized, delayed, and inequitable. Pulmonologists often play a critical role for patients with lung cancer and are in a position to facilitate biomarker testing as they commonly perform or direct the initial diagnostic biopsy, help to determine stage, and refer for treatment. Previous data show variability in knowledge and practices for ordering biomarker testing, with practice in community settings being associated with less ordering. The purpose of this investigation is to further examine the how pulmonologists view their role longitudinally across the continuum of lung cancer care, with especial focus on precision medicine and pulmonologists in community settings. The purpose of this study is to better understand how pulmonologists view their role across the lung cancer care continuum and inform future interventions to improve precision medicine delivery for patients. METHODS: This cross-sectional study was accomplished through distribution of an electronic survey consisting of 31 items focused on attitudes and practices of pulmonologists for obtaining the diagnosis, staging, biomarker testing, and treatment referral for patients with advanced NSCLC. Eligible participants were pulmonologists seeing outpatients at least once per week. A $50 electronic gift card incentive was offered for survey completion. A total of 8,444 pulmonologists in the Chest Analytics database were randomly selected to participate. Inferential statistics were performed using Chi2 and Mann-Whitney U tests, as appropriate. RESULTS: A total of 401 pulmonologists responded to the survey. The majority (92%) were general pulmonologists (8% interventional pulmonology) who practice in urban (50%) and suburban (42%) settings across the US. One-third of respondents (32%) indicated that they do not participate in their institution’s tumor board. Most respondents (83%) identified pulmonologists as having the leading responsibility to direct or perform biopsies for advanced NSCLC. About half (45%) of pulmonologists identified their specialty as having the leading responsibility for staging and less often as leading discussions about biomarker testing with patients (28%), ordering biomarker testing (22%), communicating test results (21%) or educating about potential therapeutic options (12%). Over half (58%) of pulmonologists surveyed indicated that they order biomarker testing. Longer practice tenure, higher case volumes, and participation in a multidisciplinary tumor board were associated with ordering biomarker testing (p<0.05). The most cited reason for not ordering biomarker testing was that oncology was responsible (84%), and nearly half either consider test ordering out of their scope of practice (46%) or report they lack the necessary knowledge (51%). CONCLUSIONS: Our investigation provides three key insights that inform the current state for how pulmonologists are integrated into the initial diagnostic process for patients with NSCLC. First, community pulmonologists vary in their practices for whether they order biomarker testing and many defer this responsibility completely to oncology. Secondly, despite the role of bronchoscopy and pulmonology societal guidelines for staging, many defer leadership of staging with further decline of their involvement in the steps afterwards. Finally, many pulmonologists lack the necessary resources and multi-disciplinary infrastructure likely required to efficiently utilize biomarker testing. CLINICAL IMPLICATIONS: Pulmonologists represent an important target for interventions aiming to improve precision medicine delivery to patients with NSCLC. DISCLOSURES: Stockholder relationship with Merck Please note: $20001 - $100000 by Adam Fox, value=Ownership interest Stockholder relationship with MMM Please note: $20001 - $100000 by Adam Fox, value=Ownership interest Consultant relationship with Olympus Corporation of America Please note: Fall 2022 Added 04/06/2023 by Adam Fox No relevant relationships by Paul Nietert No relevant relationships by Mark Rudzinski Consultant relationship with olympus america Please note: $1001 - $5000 by Gerard Silvestri, Scientific Medical Advisor relationship with olympus america Please note: $20001 - $100000 by Gerard Silvestri, Consultant relationship with biodesix Please note: $1001 - $5000 by Gerard Silvestri, Scientific Medical Advisor relationship with biodesix Please note: $20001 - $100000 by Gerard Silvestri, Scientific Medical Advisor relationship with oncocyte Please note: $5001 - $20000 by Gerard Silvestri, Consultant relationship with aztrazeneca Please note: $1001 - $5000 by Gerard Silvestri, Scientific Medical Advisor relationship with veran medical Please note: $20001 - $100000 by Gerard Silvestri, Scientific Medical Advisor relationship with auris medical Please note: $20001 - $100000 by Gerard Silvestri, Consultant relationship with auris medical Please note: $5001 - $20000 by Gerard Silvestri, Consultant relationship with Acacia Pharmaceutical Please note: 2019- present by Gerard Silvestri," @default.
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• W4387251657 date "2023-10-01" @default.
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• W4387251657 title "PULMONOLOGISTS' ATTITUDES AND ROLE IN PRECISION MEDICINE BIOMARKER TESTING FOR NON-SMALL CELL LUNG CANCER" @default.
• W4387251657 doi "https://doi.org/10.1016/j.chest.2023.07.4192" @default.
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