Dr Sabari on Barriers to Biomarker Testing in NSCLC

Joshua K. Sabari, MD, assistant professor, Department of Medicine, New York University (NYU) Grossman School of Medicine; director, High Reliability Organization Initiatives, Perlmutter Cancer Center, discusses barriers to biomarker testing in patients with non–small cell lung cancer (NSCLC), as well as the structure of the multidisciplinary team he uses to optimize patient outcomes.

A significant barrier to effective biomarker testing in NSCLC is a lack of education and knowledge about this testing among oncologists, Sabari begins. Moreover, patient access to financial reimbursement for biomarker tests is a global challenge, he notes. However, when the correct information from these tests is available, these results can be actionable, Sabari emphasizes. For instance, although some uncommon EGFR exon 20 insertion mutations, such as FQEA and LQEA insertions, can be responsive to osimertinib (Tagrisso), many other EGFR exon 20 insertions are not, he reports. Therefore, ongoing education and collaboration among oncology professionals is necessary to address this need. Medical oncologists specializing in lung cancer management should consult their colleagues when they encounter rare mutations, such as PAK mutations—especially in complex cases involving compound mutations or central nervous system metastases, Sabari says. Additionally, further drug development is needed to improve therapeutic options for patients with high-risk NSCLC.

At NYU’s Perlmutter Cancer Center, collaboration between specialists in thoracic medical oncology, thoracic surgery, radiation oncology, molecular pathology, and radiology facilitates comprehensive patient care, Sabari emphasizes. These experts often meet in joint clinics and molecular tumor boards to discuss complex cases and devise optimal treatment plans for individual patients, Sabari explains. This interdisciplinary collaboration, along with a robust research portfolio that includes numerous clinical trials, ensures that patients experience the best possible outcomes, according to Sabari. This integration of research and clinical practice allows for innovative treatment strategies to emerge and improve patient care, he concludes.