Dr Davey Daniel on the Importance of Biomarker Tests for Patients With Lung Cancer

Biomarker testing is a key tool in lung cancer treatment, and smoking-related lung cancer remains common in states such as Kentucky and Tennessee, says Davey B. Daniel, MD, chief medical officer at OneOncology. Kentucky recently passed a law requiring payers to cover biomarker tests, with the intention to address high rates of lung cancer in the state.

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Kentucky recently passed a law to require payers to cover the cost of biomarker tests. Do you see this as a necessary step in other states where OneOncology has partner practices?

Appropriate biomarker testing is so key to modern oncology. Whether payers are going to do it themselves, such as a large payer recently announced that they were stepping forward and doing themselves, or we're going to require through legislation. This is a decade late, and it's time that appropriate testing is paid for it and covered. When you talk to individual providers, what the biggest barrier is, it's almost always payer. It's not physician education or patient willingness—it's actually all about that cost and whether it's going to get covered appropriately. By and large, most of our practices don't have a large problem with this, but we do know there are areas of the country where either coverage is poor, or they're insisting upon very narrow panels, and when you assist on a narrow panel, then later on, you know that you're going to have to think about additional testing and the question is, when do you do that additional testing? Sometimes we're going to miss patients. And by enforcing kind of a little bit broader panel—appropriate coverage—we're going to make sure that everyone's treated equally.

Is this an especially important step in a state such as Kentucky with high rates of lung cancer?

Genetic testing, somatic testing for cancer is appropriate for many, many different tumor types, but we know in lung cancer, it's where we first saw the need and necessity of it.

I practice in Tennessee, and I still see a lot of smoking-related lung cancers — it's actually what I do all the time. We need testing appropriate across lung cancer, but we know that we need to really identify, in high smoking states, where you might have a [cellular mesenchymal-epithelial transcription factor] c-Met infusion and others, that they need comprehensive testing as well. And so, I'm pleased that Kentucky realized this is such a need.