Update: Implementation Of A Multidisciplinary Quality Improvement Initiative To Improve Molecular Testing Rates In Advanced Non-Squamous Non-Small Cell Lung Cancer.

e18085 Background: EGFR mutations and ALK rearrangements are key targets in nonsquamous nonsmall cell lung carcinoma (nsNSCLC). Treatment with targeted therapy has been shown to improve progression-free survival and overall survival in many lung cancer patients. Current guidelines recommend evaluating all advanced nsNSCLC patients for these targets; however, previous work within our institution revealed that we were not testing a large segment of eligible patients. In order to improve testing rates, we utilized multidisciplinary meetings aimed at direct physician education and process/work-flow enhancement in order to improve our testing rates. We found a significant improvement in testing rates following this intervention, however, whether or not this improved rates were durable/sustainable was unclear. To determine whether this improvements were sustained we analyzed an additional two years of data from our registry. Methods: Utilizing the Association of Community Cancer Centers (ACCC) molecular testing framework, we launched a lean six sigma initiative aimed at improving our molecular profiling rates in 2014. A series of multidisciplinary meetings were conducted addressing key action items as outlined by the ACCC. Since this intervention, a total of 419 advanced nsNSCLC patients were identified from our tumor registry (2014-2017). Testing rates for EGFR and ALK were determined by individual chart review and compared to our previously published testing rates (2011-2013). Results: We found 81.1% (340/419) and 69.0% (289/419) of patients were tested for EGFR mutations and ALK rearrangements, respectively. We utilized a chi-square test of homogeneity to determine whether there was an increased EGFR and ALK testing rate post-intervention. Our EGFR testing rate increased 87.7%, from 43.2% (2011-2013) to 81.1% (2014-2017), p < 0.00001, and our ALK testing rate increased 189.9%, from 23.8% (2011-2013) to 69.0% (2014-2017), p < 0.00001. Further, the rates testing were comparable or even improved year-over-year post intervention indicating a sustained improvement following the quality improvement initiative. Conclusions: Multidisciplinary educational and process enhancement meetings help to improve molecular testing rates in nsNSCLC. In addition, the updated analysis suggests these improvements were durable year-over-year.