Disparities in Biomarker Testing and Clinical Trial Enrollment Among Patients With Lung, Breast, or Colorectal Cancers

In a study recently published in JCO Precision Oncology, authors identified disparities in next-generation sequencing (NGS)-based testing rates between Black and White patients in non-small cell lung cancer (NSCLC) and metastatic colorectal cancer (CRC), calling on a need for interventions to promote access to comprehensive testing for patients with advanced/metastatic tumors (2022; 6:e2100427. doi:10.1200/PO.21.00427. PMID: 35737912).

Tumor biomarker testing represents a key process in determining effective molecularly driven therapies for a wide variety of solid tumors. Utilizing a real-world database, Debora S Bruno (University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center, Cleveland, OH) and colleagues aimed to examine racial differences in biomarker testing and clinical trial participation among US patients.

In all, 23,488 patients in a real-world de-identified database who had been diagnosed with advanced or metastatic NSCLC, CRC, or metastatic breast cancer met eligibility requirements. Researchers utilized chi-squared test and stepwise logistic regression controlling for baseline covariates to compare biomarker testing and clinical trial participation between black and white patients.

The study showed that when comparing White and Black patients, NGS testing rates were significantly different prior to first-line therapy (36.6% vs 29.7%, P <0.0001); rates were similar among White (51.6%) vs Black (41.8%) patients (P <0.0001) with CRC. It also showed significant differences at any given time between White (54.7%) and Black (43.8%) patients (P <0.0001) in the nonsquamous NSCLC cohort.

In the breast cancer cohort, there were no differences observed; however, Black patients (2.1%) were less likely than their White counterparts (3.9%) to be treated in a clinical trial in the overall NSCLC cohort (P = 0.0002). After adjusting for covariates, a statistically significant relationship was observed in all cohorts (P <0.003) between biomarker/NGS testing and clinical trial enrollment.

Researchers found that significant disparities were observed in a real-world database in NGS-based testing rates in NSCLC and CRC between Black and White patients.

“There is a need for interventions to promote access to comprehensive testing for patients with advanced/metastatic tumors,” the researchers concluded.