Two abstracts using data from CancerLinQ®, a health technology platform developed and implemented by ASCO to improve cancer care quality and advance evidence-based research, will be presented as posters at the 2023 ASCO Quality Care Symposium to be held in Boston on October 27-28.
In the first, “Implementing a BRAF biomarker electronic clinical quality measure in CancerLinQ (Abstract #418; first author Caitlin Drumheller, ASCO),” the investigators tested the implementation of three versions of the technical specifications of an electronic Clinical Quality Measure (eCQM) BRAF Mutational Analysis Results Received for Patients Treated for Metastatic Colorectal Cancer against data from 61 organizations and multiple electronic health record (EHR) systems in the CancerLinQ database. They analyzed the availability of required data elements in native and curated data, and variability and frequency of BRAF mutation testing documentation. The authors found that BRAF information is frequently not available in structured data fields and often lacks specificity for the specific variant tested, making the measure unsuitable for consensus endorsement or use in federal reporting programs. Although the implementation of the measure in CancerLinQ was infeasible due to the data gaps noted, this research was important in revealing current EHR shortcomings in reporting and exchanging molecular data. There remains an ongoing need for measure stakeholders to advance eCQM standards necessary for supporting future eCQM deployment.
In the second abstract, “Uptake and efficacy of immuno-oncology combinations in metastatic renal cell carcinoma in the United States: Evidence from the ASCO CancerLinQ Discovery database (Abstract #532, first author Joseph Vento, MD, Vanderbilt University Medical Center),” the investigators presented an analysis of the trends in uptake and efficacy of immune-oncology (IO) drug combinations in the frontline treatment of patients with metastatic clear cell renal cell carcinoma (mccRCC) in the US between 2018-2022, using data from the CancerLinQ Discovery kidney cancer dataset. Of 515 mccRCC patients who received frontline IO agents, 44.3% received a combination of 2 IO agents, 29.7% received an IO agent and a tyrosine kinase inhibitor (TKI), and 23.7% received IO monotherapy. An increasing trend of IO/TKI use was noted from 2019-2021. The median time to treatment discontinuation (TTD), a real-world data endpoint, for the ipilimumab/nivolumab combination was 8.5 months and was 11.0 months for the pembrolizumab/axitinib combination. When compared to progression-free survival (PFS) from landmark trials, this analysis showed a shorter TTD, suggesting either an underestimation of the true PFS or worse outcomes in this real-world population. This research demonstrated the importance of studying outcomes of newly approved agents and combinations for patients with metastatic disease using real-world datasets, where many patients may not have been candidates for clinical trial inclusion due to comorbidities, advanced age, or other factors.
