CGP-based IO biomarker assessment and treatment utilization across a major US health system.

• DOI: 10.1200/jco.2024.42.16_suppl.e23109
• Publication Date: 2024-06-03T20:56:51Z
• Authors: Alexa K. Dowdell; Ryan Meng; Roshanthi K. Weer...; Ann Vita; Bela Bapat; Douglas Hanes; Brock Schroeder; Maude Champagne; John Leonard Fox; Cliff Wong; Hoifung Poon; Carlo B. Bifulco; Brian Piening
• Keywords: 03 medical and health sciences; 0302 clinical medicine

e23109 Background: Immune checkpoint inhibitors (IO) have become a powerful precision therapy option to treat advanced stage cancer with biomarkers such as PD-L1, tumor mutational burden (TMB), and microsatellite instability (MSI) associated improved patient response rates. Despite this, many patients do not receive genomic testing for all IO biomarkers. Providence, large US community health system, developed pathologist-directed protocol where comprehensive profiling (CGP) was routinely used at time of diagnosis patients. Methods: Advanced who received CGP (ProvSeq 523) IHC PD-L1 between 2019-2023 were included in the study. Patients required be treated Providence assessed presence subsequent selection. Real world data curated from charts laboratory by employing novel natural-language processing (NLP) approach accelerate abstraction. Results: The study 2,502 (53% female, median age 68y, 83% white). Top 3 types tested lung (40%), colorectal (9%), breast (8%). Overall, 58% (N = 1,455) had ≥1 biomarker, 46% 1,155) being positive, 27% 682) TMB-H. In negative 1,347; 54%), 300 (22%) TMB-H 18 (1%) MSI-H. 53% 767) harbored an actionable biomarker IO-based therapy. Fewer chemotherapy compared without (23% vs 35%, p < 0.001). possessed ≥2 68% 47% 1 (p patients, 26% 78) monotherapy 5% 49) TMB-L Conclusions: is increased use. identified that would been missed alone. More than half eligible don’t it; ongoing analyses will evaluate impact pathology-directed reflex on well targeted approaches. [Table: see text]