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Volume 10
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10.1080/20016689.2022.2077905
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Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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Article

Barriers in Precision Medicine Implementation among Advanced Nonsquamous Cell Lung Cancer-patients: A Real-World Evidence Scenario

by
Flavia A. Duarte
1,*,
Carlos Gil Ferreira
2,
Rodrigo Dienstmann
3,
Bruno L. Ferrari
1,
Matheus Costa E Silva
3,
Pedro Nazareth A. Junior
3,
Paulo Guilherme de O. Salles
4 and
Paulo Henrique C. Diniz
1
1
Oncology Department, Oncoclínicas do Brasil, Rua Roma 561, 4th floor, Santa Lúcia, Belo Horizonte 30360-680, MG, Brazil
2
Oncology Department, Oncoclínicas Institute, Rio de Janeiro, Brazil
3
Precision Medicine and Big Data Department, Oncoclínicas Group, São Paulo, Brazil
4
Pathology Department, Roberto Alvarenga Institute, Belo Horizonte, Brazil
*
Author to whom correspondence should be addressed.
J. Mark. Access Health Policy 2022, 10(1), 2077905; https://doi.org/10.1080/20016689.2022.2077905
Submission received: 2 December 2021 / Revised: 21 April 2022 / Accepted: 11 May 2022 / Published: 24 May 2022

Abstract

Background: Precision oncology has a prominent role in nonsquamous non-small cell lung cancer (nsNSCLC) treatment progress; however, its access in a real-world scenario might be limited. Objective: To investigate the time spent in nsNSCLC molecular profile evaluation and its influence on clinical decisions. Methods: nsNSCLC patients who underwent molecular testing in a private referral Brazilian center between November 2015 and February 2020 were identified. The interval from nsNSCLC diagnosis to the characterization of the molecular profile was determined. Other outcomes, focusing on the biomarker tissue journey, were also assessed. Results: In this cohort (n = 78), the median time between the advanced nsNSCLC diagnosis and biomarker characterization was 40.5 days (range, 29.5–68.5). The median interval between the diagnosis and the test request was longer than the interval between the request and the results (respectively 29.0 versus 12.0 days; p < 0.001). At the treatment initiation, 51% (36/71) of the patients who received any systemic therapy did not have their driver mutations panel results available. But on these, 42% (15/36) had a targetable alteration identified later on. Among patients harboring a targetable alteration, only 46% (n = 13/28) received a tyrosine kinase inhibitor (TKI) as first-line therapy. The median time to the TKI initiation was even longer than the median time to all treatment initiation (92.0 versus 40.0 days). Conclusions: Our data show a long median time from advanced nsNSCLC diagnosis and the availability of the biomarker testing in medical practice, which impacted the choice of a non-personalized therapy as the first-line.
Keywords: precision medicine; drug access; non-small cell lung cancer precision medicine; drug access; non-small cell lung cancer

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MDPI and ACS Style

Duarte, F.A.; Ferreira, C.G.; Dienstmann, R.; Ferrari, B.L.; Costa E Silva, M.; Nazareth A. Junior, P.; Guilherme de O. Salles, P.; Henrique C. Diniz, P. Barriers in Precision Medicine Implementation among Advanced Nonsquamous Cell Lung Cancer-patients: A Real-World Evidence Scenario. J. Mark. Access Health Policy 2022, 10, 2077905. https://doi.org/10.1080/20016689.2022.2077905

AMA Style

Duarte FA, Ferreira CG, Dienstmann R, Ferrari BL, Costa E Silva M, Nazareth A. Junior P, Guilherme de O. Salles P, Henrique C. Diniz P. Barriers in Precision Medicine Implementation among Advanced Nonsquamous Cell Lung Cancer-patients: A Real-World Evidence Scenario. Journal of Market Access & Health Policy. 2022; 10(1):2077905. https://doi.org/10.1080/20016689.2022.2077905

Chicago/Turabian Style

Duarte, Flavia A., Carlos Gil Ferreira, Rodrigo Dienstmann, Bruno L. Ferrari, Matheus Costa E Silva, Pedro Nazareth A. Junior, Paulo Guilherme de O. Salles, and Paulo Henrique C. Diniz. 2022. "Barriers in Precision Medicine Implementation among Advanced Nonsquamous Cell Lung Cancer-patients: A Real-World Evidence Scenario" Journal of Market Access & Health Policy 10, no. 1: 2077905. https://doi.org/10.1080/20016689.2022.2077905

APA Style

Duarte, F. A., Ferreira, C. G., Dienstmann, R., Ferrari, B. L., Costa E Silva, M., Nazareth A. Junior, P., Guilherme de O. Salles, P., & Henrique C. Diniz, P. (2022). Barriers in Precision Medicine Implementation among Advanced Nonsquamous Cell Lung Cancer-patients: A Real-World Evidence Scenario. Journal of Market Access & Health Policy, 10(1), 2077905. https://doi.org/10.1080/20016689.2022.2077905

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