Turnaround Times in Melanoma BRAF Testing and the Impact on the Initiation of Systemic Therapy at a Single Tertiary Care Cancer Center.

Purpose: The identification of mutations in melanoma enables targeted therapy and improves patient outcomes. Barriers to molecular testing affect the quality of care and therapeutic options.

Methods: This retrospective study mapped testing timelines in adult patients with melanoma at the Princess Margaret Cancer Centre to identify obstacles to timely reporting and its impact on the initiation of therapy.

Results: Sixty-six cases were included. The median time between request and result was 12 days (95% CI, 8 to 15) when the test was ordered by pathology, compared with 20 days (95% CI, 16 to 23) if the test was requested by another specialist ( < .001). When the test and biopsy were performed within the same institution, the median turnaround time (TAT) was 13 days (95% CI, 6 to 19) compared with 19 days (95% CI, 16 to 21) if the sample was transferred from another institution ( = .02). Forty-seven patients received systemic therapy, and 20 had metastatic disease. In the metastatic subgroup, if the result was available at the first medical oncology visit, the initiation of treatment was 20 days (95% CI, 9.6 to 30.3), but was delayed to 31 days (95% CI, 10.8 to 51.1) if the result was not available ( = .03).

Conclusion: This study showed variations in test results in TAT. One factor affecting this timeline is the transfer time, which can be streamlined by pathology reflex testing. Delays in TAT affect the timing and type of therapeutic intervention, especially in patients with stage IV disease.