Biomarker Testing Helps Guide Lung Cancer Therapy Selection: Stefanie Houseknecht, PharmD

As lung cancer treatments become more biomarker-driven, oncology pharmacists play an increasingly important role in reviewing operational and clinical considerations as their roles in oncology care and patient treatment delivery intertwine.

At the Washington, DC, Institute for Value-Based Medicine^®, a panel comprising lung cancer specialists across community and academic practices and pharmacy specialists discussed the logistical and clinical applications required to successfully adopt, implement, and manage targeted therapies for patients with lung cancer.

Pharmacists, specifically, as they become more involved in managing patient care, need to make sure patients receive the proper testing, panelist Stefanie Houseknecht, PharmD, an oncology pharmacy specialist at Johns Hopkins Hospital, said in an interview with The American Journal of Managed Care^®.

“That's really important because we don't want patients getting started on the wrong therapy,” she said. “There have been numerous studies that have shown that outcomes, including overall survival, are worse when patients who have a biomarker that makes them eligible for a biomarker therapy don't actually get that therapy.”

Biomarker testing is pivotal because it determines whether patients are eligible for targeted therapies. This is especially crucial when treating lung cancer because of the broad availability of biomarker-based therapies for patients, Houseknecht said. There are 2 HER2-positive targeted therapies, zongertinib and seviberitinib, and in RET fusion-positive lung cancer, there are pralsetinib and selpercatinib, she explained.

“They're equally efficacious for the most part, and what differs is the toxicity, how they're administered, and some of the monitoring parameters,” Houseknecht said. “And that's really where a pharmacist comes in because we can take a look at the patient profile….[and] we can help choose a therapy as part of the treatment team that's most likely to be successful for the patient.”

Pharmacist-patient communication also plays a role in patient readiness, especially in stage IV lung cancer diagnosis, she said. “Pharmacists provide a number of additional opportunities to reinforce the education that has been given to them by the medical oncologist,” Houseknecht said, “[which] really gives them the autonomy to take control of their care and be an active member of their care team.”