P2.15-13 Implementation of a Democratized Approach to Multi-Omic Molecular Profiling Via the LungMATCH Program.

Abstract

For metastatic non-small cell lung cancer (NSCLC) guidelines include molecular testing for actionable biomarkers and recommend broad profile testing. Previous studies indicate that many patients with NSCLC are not receiving testing, even for actionable changes in EGFR, ALK, and ROS, BRAF, and PD-L1. There are widespread gaps in the community setting and Lung Cancer Alliance data shows that less than 50% of callers to the patient HelpLine have had molecular testing on their lung cancer. The LungMATCH molecular testing program is operationalized via a turn-key precision medicine (PM) operation system. This approach provides a standardized workflow from tissue acquisition through multi-omic molecular profiling, treatment history integration, and AI-based computational analysis to produce a treatment decision support tool of therapeutic options matched to the patient. Longitudinal outcome is collected on every patient along with treatment decisions and patient experience. The majority of the patient referrals (72%) came from non-academic centers across a wide geographic region that covered nearly 75% of the United States (36/50 states). Barriers to signing informed consent and completing biopsy have been identified including: patients in poor health, cost concerns, unsupportive physicians, and patient loyalty to the physician (discomfort with advocating for testing). For patients who have received reports, 72% (12/17) had actionable genomic alterations that indicated either a standard of care agent or a clinical trial. An additional 82% (9/11) had actionable proteomic findings and 31% (5/16) had high tumor mutational burden. There is broad patient interest in accessing PM information but still many barriers to widespread adoption. The LungMATCH program provides a turn-key solution to help provide a facile means to “democratize” access to PM information unbound by geography or community/academic setting. Importantly, the majority of patients who received a completed profiling report had actionable molecular alterations, which underscores the potential impact of testing. Treatment decisions and patient outcomes continue to be followed.