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Surveys Reveal Opportunity for Medical Community to Fully Embrace Biomarker Testing in Lung Cancer
Date:5/7/2013

RIDGEFIELD, Conn., May 7, 2013 /PRNewswire/ -- Boehringer Ingelheim Pharmaceuticals, Inc. (BIPI) today announced results of two surveys that explored how pulmonologists and pathologists are incorporating biomarker testing into the care of patients with lung cancer. The results point to an increased role of these physicians in biomarker testing as well as greater multidisciplinary collaboration. However, they also reveal that an opportunity exists to improve how soon these tests are requested and to identify challenges with testing, including collecting a sufficient amount and quality of lung tissue.

Biomarker testing – the practice of testing tissue for a specific genetic mutation or translocation, known as a biomarker – is critical in the diagnosis of lung cancer, as it helps physicians determine a patient's specific type of cancer and inform a personalized treatment approach.

"These surveys provide perspective on the continued need for a multidisciplinary approach to biomarker testing to ultimately support personalized care of patients with lung cancer," said William Goeckeler , PhD, director, Oncology Medical Affairs, Boehringer Ingelheim Pharmaceuticals, Inc. "Automatic biomarker testing is critical for an accurate diagnosis as it helps match each patient with the most appropriate therapy as early as possible."

The surveys were sponsored by BIPI and conducted online by Harris Interactive in November and December 2012. The first survey consisted of 100 pulmonologists practicing in the U.S. and the second consisted of 250 pathologists practicing in the U.S.

Differing Perspectives on Testing
Survey responses revealed the need for consistent guidelines on the size and quality of tissue needed to perform biomarker testing.

  • Both pulmonologists and pathologists said the biggest challenges with biomarker testing include not always acquiring a tissue sample that is sufficient in size (60% and 73%, respectively) or quality (31% and 39%, respectively).
  • About half of pulmonologists (41%) do not believe they have enough information about the size of tissue needed.

These findings are similar to results of a previous BIPI survey from 2011 of 95 community oncologists, also conducted online by Harris Interactive: nearly half (42%) stated they did not have sufficient information about the tissue sample size needed to test for a certain mutation.

The recent surveys also highlighted a difference of opinion around the most appropriate tissue acquisition methods. For example:

  • Fifty-one percent of pulmonologists surveyed believed endoscope biopsy to be the method yielding the most appropriate balance between quantity and quality of tissue and risk to the patient; just 15 percent of pathologists agreed.
  • One-third of pulmonologists (33%) believed fine needle aspiration to be the best method; only 10 percent of pathologists agreed.
  • Interestingly, 63 percent of pathologists and 44 percent of pulmonologists believe core biopsy to be the most appropriate method.

Opportunity for Greater Adoption of "Reflex" Testing
Through reflex – or automatic – testing, tissue samples are tested for biomarkers immediately after a non-small cell lung cancer (NSCLC) diagnosis. This way, oncologists receive the results at the patient's first visit, with the goal of initiating the most appropriate therapy as early as possible. The results from surveyed pulmonologists and pathologists suggest that they have started to embrace reflex testing, but there is a potential to increase its use:

  • Nearly half (43%) of pulmonologists implement reflex testing of NSCLC patients in their practice or local healthcare community.
  • One-third of pathologists (33%) say such reflex testing has been implemented in their practice.

Biomarker testing has significant implications for patients because, as revealed in the 2011 survey of community oncologists, of those who said they order biomarker testing, 89 percent (78/88) stated that genetic mutation testing helps with treatment decisions. All of the 95 community oncologists surveyed plan treatment differently for lung cancer patients who have a genetic mutation.

The Growing Role of the Multidisciplinary Team
A multidisciplinary approach to a patient's lung cancer diagnosis is important, as it can help streamline the testing process and personalize treatment decisions. Results from surveyed pulmonologists and pathologists suggest that they are increasingly utilizing a multidisciplinary approach – which is good news for patients:

  • Pulmonologists and pathologists report having increased discussions with a multidisciplinary team over the past five years (65% and 57%, respectively).
  • Majorities of pulmonologists and pathologists consult with oncologists (85% and 92%, respectively).

"The medical community is moving in a positive direction, but an opportunity exists for greater collaboration in incorporating biomarker testing into a patient's care early on, with the goal of initiating an appropriate lung cancer treatment plan as soon as possible," said Kevin Lokay , vice president and business unit head, Oncology, Boehringer Ingelheim Pharmaceuticals, Inc. "We are proud to be part of this movement, and it is encouraging to see how this multidisciplinary approach to testing is already having a significant impact on the diagnosis and care of cancer patients."

The surveys complement BIPI's Let's Test initiative, which aims to educate healthcare professionals about the important role they play in the diagnosis and treatment of NSCLC, and the critical role of biomarker testing. The initiative, which also highlights the need for a multidisciplinary approach, demonstrates Boehringer Ingelheim's commitment to advancing the care and outcomes for patients with cancer.

About Pulmonologists and Pathologists 
Pulmonologists specialize in treating diseases of the lungs and many times, they are the biopsying physicians who collect tumor tissue from patients with lung cancer. Pulmonologists are often involved in the early diagnosis of lung cancer – when patients present with symptoms– and referral of patients to oncologists.

Pathologists specialize in medical diagnosis and can aid in establishing practices and procedures to standardize biomarker testing in advanced NSCLC. Once lung tissue is obtained and assessed, pathologists have the opportunity to select and run appropriate biomarker tests in the lab.

About the Survey and Methodology
Between November 19 and December 27, 2012, BIPI sponsored two surveys to measure perceptions and knowledge of biomarker testing and to identify unmet needs and gaps in testing practice. The two surveys were conducted online by Harris Interactive.

The survey of pulmonologists was developed by BIPI. The American College of Chest Physicians (ACCP) participated with BIPI by obtaining professional participants for the survey. One hundred practicing pulmonologists in the U.S. participated. Data were not weighted and are representative of the population of pulmonologists who were surveyed. The survey of pathologists was developed by BIPI. Two hundred and fifty practicing pathologists – sampled from an American Medical Association database – in the U.S. participated. Data were weighted based on years in practice by gender.

These surveys were a follow-up to a series of surveys, conducted online in 2011, of patients with lung cancer (n=436), community oncologists (n=95), and lung cancer/oncology nurses (n=522) to assess the general awareness of biomarker testing within the lung cancer community. Results revealed varying degrees of awareness and a need to improve communication around biomarker testing between healthcare professionals and patients with lung cancer. The 2011 survey series was sponsored by BIPI in partnership with the Association of Community Cancer Centers, National Lung Cancer Partnership and ONS:Edge, a subsidiary of the Oncology Nursing Society, and conducted by Harris Interactive. A full methodology is available upon request.

About Lung Cancer
In the United States, lung cancer is the second most common cancer. In 2013, an estimated 228,190 new cases will be diagnosed in the United States and an estimated 159,480 Americans will die from the disease.[1]  NSCLC is the most common form of lung cancer, accounting for about 85 percent of all diagnoses.[2] 

About Boehringer Ingelheim Pharmaceuticals, Inc.
The Boehringer Ingelheim group is one of the world's 20 leading pharmaceutical companies. Headquartered in Ingelheim, Germany, it operates globally with 140 affiliates and more than 46,000 employees. Since it was founded in 1885, the family-owned company has been committed to researching, developing, manufacturing and marketing novel medications of high therapeutic value for human and veterinary medicine.

As a central element of its culture, Boehringer Ingelheim pledges to act socially responsible. Involvement in social projects, caring for employees and their families, and providing equal opportunities for all employees form the foundation of the global operations. Mutual cooperation and respect, as well as environmental protection and sustainability are intrinsic factors in all of Boehringer Ingelheim's endeavors.

In 2012, Boehringer Ingelheim achieved net sales of about 14.7 billion euro. R&D expenditure in the business area Prescription Medicines corresponds to 22.5% of its net sales.

For more information please visit www.boehringer-ingelheim.com

References

[1] American Cancer Society. Cancer Facts and Figures: 2013. Available at: http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-036845.pdf. Last accessed March 29, 2013.
[2] American Cancer Society. Lung Cancer (Non-Small Cell). Available at: http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-key-statistics.


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