This research, led by Grace K. Kane, Douglas Londono, and Nathan J. Markward, explores how the timing of biomarker testing affects survival outcomes in patients with non-small cell lung cancer (NSCLC). Using real-world claims data, it identifies disparities in testing and treatment patterns and their impact on mortality rates.
Biomarker testing is essential to advancing precision medicine in NSCLC, yet many patients do not receive it early enough, or at all.
This retrospective analysis draws from PurpleLab’s CLEAR Claims database, studying nearly 150,000 NSCLC patients between January 2020 and July 2024. Researchers evaluated how test timing, treatment sequences, social determinants of health, and provider behavior influence patient survival.
Patients were grouped based on:
- Whether testing occurred before or after therapy began
- Their treatment pathway (chemotherapy, targeted therapy, no treatment)
- The frequency of testing by their healthcare provider
Survival outcomes and mortality trends were analyzed using Cox regression models and Kaplan-Meier curves.
Key Findings
- Early testing saves lives: Patients tested early and treated with chemotherapy plus targeted therapy (B+C+T) had the longest median survival: 592 days.
- Lower risk of death: Early biomarker testing was associated with an 8% reduction in mortality hazard.
- Clear disparities:
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- Married patients had better survival outcomes (HR=0.87) than single patients.
- African American patients had a higher risk of death (HR=1.06) compared to White patients.
- Provider impact: Patients whose providers tested consistently (top testing quintile) had lower mortality (~57.3%) than those with less frequent testing (~62.5%).
- Worst outcomes: Patients who received testing but no follow-up treatment, or no treatment at all, had the lowest survival probabilities.
See the full research poster below for more details.
