WCLC 2025 - Posters & ePosters-P2.15 .31 Integrating Biomarker Testing in Early-Stage Lung Cancer With a Nurse-Led Multidisciplinary Approach Using the 4R Oncology Model

P2.15 .31 Integrating Biomarker Testing in Early-Stage Lung Cancer With a Nurse-Led Multidisciplinary Approach Using the 4R Oncology Model

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This study evaluates the impact of the 4R Oncology model—a nurse-led, multidisciplinary care approach—on biomarker testing timeliness and rates in patients with operable early-stage non-small cell lung cancer (NSCLC). Biomarker testing, essential for guiding neoadjuvant and adjuvant treatments, is often delayed under usual care, impeding prompt treatment decisions.<br /><br />The 4R model (Right Info/Care/Patient/Time) uses personalized one-page Care Sequences to coordinate multidisciplinary oncology, supportive, and social care efficiently without added resources. In this prospective cohort study at Kaiser Permanente Northern California, patients with Stage I-III NSCLC receiving care via the 4R model were compared to those receiving usual care. The 4R group was facilitated by nurse navigators and allied health professionals who expedited testing by ordering upon pathology report and managing interdisciplinary communication.<br /><br />Results from the interim analysis of 42 patients in the 4R group vs. 139 controls showed the 4R approach dramatically increased biomarker testing rates (100% vs. 40%, p=0.001) and significantly reduced median time from surgery to test results (6 vs. 26 days, p=0.03). Testing on diagnostic biopsy samples was also higher (79% vs. 26%, p=0.001). Patient demographics and clinical characteristics were similar across groups.<br /><br />These findings suggest the 4R nurse-led model can enhance adherence to biomarker testing guidelines and accelerate result availability, thus supporting timely, personalized lung cancer treatment. The approach offers a scalable framework leveraging nursing and allied health roles to improve complex cancer care delivery without additional staffing. Limitations include the small sample size, lack of randomization, and single-system setting, potentially limiting generalizability.<br /><br />In summary, the 4R Oncology model shows promise to improve biomarker testing integration in early-stage NSCLC care, facilitating faster treatment decisions and potentially better outcomes. A final analysis will be conducted to confirm these interim results. This work may inform broader adoption of multidisciplinary, nurse-facilitated care models to optimize timely testing and precision oncology for lung cancer patients.

Asset Subtitle

Raymond Liu

Meta Tag

Speaker Raymond Liu

Topic Multidisciplinary Care: Nursing, Allied Health and Palliative Care

Keywords

4R Oncology model

nurse-led care

multidisciplinary care

biomarker testing

non-small cell lung cancer

early-stage NSCLC

timeliness of testing

patient outcomes

precision oncology

Kaiser Permanente Northern California