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Eliminating Precision Medicine Disparities Overview

Identification of actionable biomarkers continues to drive application of precision medicine in oncology. For patients with lung cancer, molecularly targeted therapies based on expression of specific biomarkers may be potential treatment options. Only through biomarker testing can clinicians discover whether lung cancers have targetable biomarkers.

Despite increasing evidence supporting the role of biomarkers in treatment decision-making for patients with lung cancer, recent studies1-3 report that more than 70 percent of patients treated in the community do not receive biomarker testing as recommended by National Comprehensive Cancer Network (NCCN) clinical practice guidelines, and more than 50 percent of patients do not receive appropriate precision medicine therapies based on the test results.2 Among underserved patient populations, the gap is even wider.4,5 Analysis of CMS claims data has revealed that Medicaid patients are 40 percent less likely to get tested than patients with private health insurance and Medicaid patients are 30 percent less likely to receive targeted therapies after testing, compared to patients with private health insurance.4

The ACCC Eliminating Precision Medicine Disparities project is focused on understanding specific barriers and challenges to equal access to precision medicine among underserved patient communities. Through this project, ACCC seeks to:

  • Evaluate patient and provider perceptions of equity in access to biomarker testing and gaps in access to appropriate precision medicine therapies based on identification of actionable biomarkers.
  • Gather feedback from patients and healthcare providers regarding specific barriers and challenges in obtaining biomarker testing and access to precision therapies.
  • Develop interventions for both patients and providers to promote biomarkers testing for patients with lung cancer in underserved communities.

The project is guided by an expert multidisciplinary Advisory Committee. ACCC is pleased to partner with LUNGevity for the patient-facing components of this education intervention.

For more information about this project, please contact Lorna Lucas, Senior Director, Provider Education at ACCC.


Video Podcast

From Oncology Issues

v37n1-Patient-Perceptions-of-Biomarker-Testing-60x60Patient Perceptions of Biomarker Testing
Nikki Martin, MA; Lisa Dropkin; Lydia Redway; Mariel Molina; Janelle Schrag, MPH; Latha Shivakumar, PhD, CHCP; Leigh M. Boehmer, PharmD, BCOP; and Upal Basu Roy, PhD, MPH

As precision medicine becomes more common in the management of lung cancer, little is understood about the patient experience with biomarker testing, particularly of underserved patients. This study used survey and focus group methodology to determine patient perspectives on the educational needs within this community.

Appendix A: Patient Survey
Appendix B: Focus Group Guide

Presentations & Abstracts


  1. Gutierrez ME, Choi K, Lanman RB, et al. Genomic profiling of advanced non-small cell lung cancer in community settings: gaps and opportunities. Clin Lung Cancer. 2017;18(6):651-659.
  2. Mason C, Ellis PG, Lokay K, et al. Patterns of biomarker testing rates and appropriate use of targeted therapy in the first-line, metastatic non-small cell lung cancer treatment Setting. J Clin Pathw. 2018;(1):49–54.
  3. Audibert CM, Shea MB, Glass DJ, et al. Trends in the molecular diagnosis of lung cancer: results from an online market research survey. Washington, DC: Friends of Cancer Research; 2018.
  4. Palazzo LL, Sheehan DF, Tramontano AC, et al. Disparities and trends in genetic testing and erlotinib treatment among metastatic non-small cell lung cancer patients. Cancer Epidemiol Biomark Prev. 2019;28(5):926-934.
  5. Wong W, Wu N, et al. ALK testing trends and patterns among community practices in the United States. JCO Precis Oncol. 2018;2:1-11.

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Funding & support provided by Genentech, Janssen, Merck & Co., and Foundation Medicine