Table 1. Targeted Therapy Measures
Measure | Numerator | Denominator |
|---|---|---|
HER2 testing for overexpression or gene amplification in patients with breast cancer | HER2 testing performed | Adult women with breast cancer |
Combination chemotherapy recommended or administered within 4 months for women < 70 with AJCC T1cNOMO, or stage IB–III hormone receptor-negative breast cancer | Combination chemotherapy is administered within 120 days of the date of diagnosis or it is recommended and not received | Women age 18–69 diagnosed with stage IB–III hormone receptor-negative breast cancer (AJCC T1cNOMO) |
Adjuvant hormonal therapy recommended or administered within 1 year of diagnosis for women with AJCC t1cNOMO or stage IB–III hormone receptor-positive breast cancer | Hormone therapy administered within 365 days of the date of diagnosis or it is recommended but not received | Adult women diagnosed with AJCC T1cN0M0 or stage IB–III hormone-positive breast tumor |
Trastuzumab administered to patients with AJCC stage I (T1c)–III and HER2-positive breast cancer who receive adjuvant chemotherapy | Trastuzumab administered within 12 months of diagnosis | Adult women with AJCC stage I (T1c)–III or HER2-positive breast cancer who receive chemotherapy |
HER2-negative or undocumented breast cancer patients spared treatment with HER2-targeted therapies | HER2 therapies not administered during the initial course of treatment | Adult women with breast cancer that are HER2-negative or HER2-undocumented |
PDL1 molecular testing of lung cancer patients presenting with advanced or metastatic disease performed within 3 months of diagnosis and prior to systemic therapy | PD-L1 testing performed prior to systemic therapy date | Adult patients with stage IV NSC lung cancer of histologic subtype adenocarcinoma, large cell, NSCLC NOS, or squamous cell carcinoma |
Molecular testing of lung cancer patients presenting with advanced or metastatic disease performed within 3 months of diagnosis | EGFR and ALK testing performed prior to the systemic therapy start date | Adult patients with stage IV NSCLC with histologic subtype adenocarcinoma or NSCLC NOS |
Targeted therapy with a checkpoint inhibitor for lung cancer patients with advanced or metastatic disease and PD-L1 > 1% and negative test results for EGFR mutations and ALK fusion within 3 months of diagnosis | Single-agent pembrolizumab delivered within 3 months of diagnosis | Adult patients with stage IV NSCLC of histologic subtype adenocarcinoma, NSCLC NOS, or squamous cell carcinoma who are EGFR-negative and ALK-negative |
Targeted therapy with a TKI for lung cancer patients with advanced or metastatic disease and positive test results for EGFR mutations within 3 months of diagnosis | Osimertinib, erlotinib, afatinib, gefitinib, or dacomitinib delivered within 3 months of diagnosis | Adult patients with stage IV NSCLC with histologic subtype adenocarcinoma or NSCLC NOS, who are EGFR-positive |
Targeted therapy with ALK inhibitor provided for patients with advanced or metastatic disease and positive test results for ALK fusion within 3 months of diagnosis | Alectinib, brigatinib, ceritinib, or crizotinib delivered within 3 months of diagnosis | Adult patients with stage IV NSCLC of histologic subtype adenocarcinoma, large cell, or NSCLC NOS, who are positive for AKL fusion |
RAS (KRAS and NRAS) testing for patients with metastatic colorectal cancer who received anti-EGFR monoclonal antibody therapy | RAS gene mutation testing performed before initiation of anti-EGFR monoclonal antibodies | Adult patients with metastatic colorectal cancer who receive anti-EGFR monoclonal antibody therapy |
Patients with metastatic colorectal cancer and RAS (KRAS or NRAS) gene mutation spared treatment with anti-EGFR monoclonal antibodies | Anti-EGFR monoclonal antibody therapy not received within the reporting period | Adult patients with metastatic colorectal cancer who have a RAS (KRAS or NRAS) gene mutation |
MMR or MSI testing for patients with metastatic colorectal cancer who receive immune checkpoint inhibitors (pembrolizumab, nivolumab, and ipilimumab) | MMR or MSI testing performed before initiation of pembrolizumab, nivolumab, and ipilimumab | Adult patients with metastatic colorectal cancer who receive pembrolizumab, nivolumab, and ipilimumab |
Patients with metastatic colorectal cancer and MMR or MSI high spared immune checkpoint inhibitors | Immune checkpoint therapy (pembrolizumab, nivolumab, and ipilimumab) not received | Adult patients with metastatic colorectal cancer who have an MMR or MSI high |
BRAF testing for patients with metastatic colorectal cancer who receive BRAF inhibitors | BRAF gene mutation testing performed before initiation of BRAF inhibitor | Adult patients with metastatic colorectal cancer who receive BRAF inhibitor |
Patients with metastatic colorectal cancer and a BRAF gene mutation spared treatment with a BRAF inhibitor | BRAF inhibitor not received | Adult patients with metastatic colorectal cancer who have a BRAF mutation |
Molecular testing of patients presenting with stage III or stage IV distant metastatic melanoma | BRAF testing performed | Patients > 18 presenting with the first and only tumor of stage III or IV melanoma |
Melanoma patients without BRAF V600 mutations or V600 exon 11 or exon 15 mutations spared BRAF inhibitors | BRAF inhibitor use | Patients > 18 with BRAF-negative, the first and only stage III or IV melanoma |
Melanoma patients with BRAF V600 mutations receiving BRAF inhibitors in combination with MEK inhibitors | BRAF inhibitor AND MEK inhibitor use | Patients > 18 with BRAF-positive, the first and only stage III or IV melanoma |