WCLC 2025 - Posters & ePosters-EP.17.17 Availability of PD-L1 and Ngs Results at Initial Medical Oncology Consultation in Patients With Non-Small Cell Lung Cancer

EP.17.17 Availability of PD-L1 and Ngs Results at Initial Medical Oncology Consultation in Patients With Non-Small Cell Lung Cancer

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This quality improvement project at The Ottawa Hospital Cancer Centre evaluated the availability of PD-L1 and next-generation sequencing (NGS) results at the initial medical oncology consultation for 100 consecutive patients with non-small cell lung cancer (NSCLC) starting October 2024. These biomarkers are critical for guiding targeted therapies and immunotherapy decisions. Reflex testing was performed: PD-L1 on all cases and NGS on non-squamous NSCLC. Patient demographics showed a median age of 71, roughly equal gender distribution, and 75% adenocarcinoma histology, with most patients presenting at stage IV.<br /><br />Results demonstrated that PD-L1 testing was performed in 99 patients and available at initial consultation in 81%, whereas NGS was done in 77 non-squamous cases but only available at consultation in 56%. Lack of timely NGS results led to additional visits for 39 patients, with some requiring up to three revisits. Five patients started treatment without NGS results, and two had subsequent treatment changes after results became available (e.g., pembrolizumab addition).<br /><br />The study highlighted that incomplete biomarker data at first consult delays decision-making, resulting in workflow inefficiencies and potential impact on patient care. The authors noted a short wait time to oncology consultation as a contributing factor and that findings may vary by center. In response, the centre implemented a new physician triage system to prioritize cases where waiting for NGS before consultation is safe, aiming to reduce unnecessary visits. A follow-up quality improvement evaluation is planned to assess the effectiveness of this approach.<br /><br />In summary, ensuring PD-L1 and NGS results are available at initial oncology visits is crucial for timely, personalized NSCLC treatment, and systems-level changes may improve test turnaround and patient management.

Asset Subtitle

Jacqueline Martin

Meta Tag

Speaker Jacqueline Martin

Topic Global Health, Health Services, and Health Economics

Keywords

PD-L1 testing

next-generation sequencing

non-small cell lung cancer

NSCLC

biomarker availability

oncology consultation

targeted therapy

immunotherapy

quality improvement

patient management