WCLC 2025 - Posters & ePosters-EP.06.15 Reflex Next Generation Sequencing Testing in NSCLC: Overcoming Barriers to Equitable Molecular Profiling in an Urban Healthcare Network ?

EP.06.15 Reflex Next Generation Sequencing Testing in NSCLC: Overcoming Barriers to Equitable Molecular Profiling in an Urban Healthcare Network ?

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This study evaluates the implementation of reflex Next-Generation Sequencing (NGS) testing for non-small cell lung cancer (NSCLC) within the Temple University Health System (TUHS), which serves three hospital sites in Philadelphia. NGS enables comprehensive genomic and transcriptomic profiling, increasingly essential for guiding targeted treatments in NSCLC, even at early disease stages. However, barriers such as limited biopsy tissue, provider variability, and logistical challenges have hindered consistent NGS testing. <br /><br />In 2023, TUHS initiated a pathology-driven reflex molecular testing protocol for both squamous and non-squamous NSCLC diagnosed from pulmonary and interventional radiology biopsies. The study retrospectively reviewed 306 NSCLC patients, of whom 277 qualified for analysis. Results showed high completion rates of NGS testing: 83.75% underwent DNA analysis, 81.95% RNA analysis, and 80.87% received both. Among patients who did not undergo NGS (15.2%), half were ineligible based on clinical stage (e.g., tumors under Stage IB or smaller than 4 cm) and thus did not require testing per guidelines.<br /><br />The reflex testing approach successfully integrated molecular profiling into diagnostic workflows across a diverse urban healthcare system, improving access to advanced treatment options. The authors note ongoing efforts to address the needs of patients who did not receive testing by investigating factors like demographics, comorbidities, biopsy methods, and tumor histology. Emphasis is placed on optimizing tissue use and further standardizing biomarker testing to reduce disparities and enhance guideline adherence.<br /><br />Overall, this study demonstrates that systematic reflex NGS testing in NSCLC can overcome common barriers and promote equitable molecular diagnostics critical for personalized cancer care in varied clinical settings.

Asset Subtitle

Brianna Graham

Meta Tag

Speaker Brianna Graham

Topic Pathology and Biomarkers

Keywords

Next-Generation Sequencing

NGS testing

non-small cell lung cancer

NSCLC

reflex molecular testing

Temple University Health System

genomic profiling

transcriptomic profiling

biopsy tissue optimization

personalized cancer care