Barriers in precision medicine implementation among advanced nonsquamous cell lung cancer-patients: a real-world evidence scenario

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dc.creatorFlavia Amaral Duarte
dc.creatorCarlos Gil Ferreira
dc.creatorRodrigo Dienstmann
dc.creatorBruno L. Ferrari
dc.creatorMatheus Costa e Silva
dc.creatorPedro Nazareth A . Junior
dc.creatorPaulo Guilherme de Oliveira Salles
dc.creatorPaulo Henrique Costa Diniz
dc.date.accessioned2023-12-01T21:11:54Z
dc.date.accessioned2025-09-09T01:00:50Z
dc.date.available2023-12-01T21:11:54Z
dc.date.issued2022
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1080/20016689.2022.2077905
dc.identifier.issn2001-6689
dc.identifier.urihttps://hdl.handle.net/1843/61656
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofJournal of Market Access & Health Policy
dc.rightsAcesso Aberto
dc.subjectMedicina de precisão
dc.subjectAcesso aos serviços de saúde
dc.subjectCarcinoma pulmonar de células não pequenas
dc.subject.otherPrecision medicine
dc.subject.otherDrug access
dc.subject.otherNon-small cell lung cancer
dc.titleBarriers in precision medicine implementation among advanced nonsquamous cell lung cancer-patients: a real-world evidence scenario
dc.typeArtigo de periódico
local.citation.issue1
local.citation.volume10
local.description.resumoBackground: 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.
local.identifier.orcidhttp://orcid.org/0000-0002-4647-9788
local.identifier.orcidhttp://orcid.org/0000-0002-7228-7018
local.identifier.orcidhttp://orcid.org/0000-0001-5997-318X
local.identifier.orcidhttp://orcid.org/0000-0001-8839-3491
local.identifier.orcidhttp://orcid.org/0000-0003-2016-5593
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE CLÍNICA MÉDICA
local.publisher.initialsUFMG
local.url.externahttps://www.tandfonline.com/doi/full/10.1080/20016689.2022.2077905

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