Levy BP, Farris BY, Crawford RR, et al. - Given that targeted therapies have greatly improved treatment choices for patients with ALK or ROS1+ NSCLC, though effective integration has been hampered by challenges personalizing care, researchers analyzed practices involving the use of targeted therapies for NSCLC in a quality improvement (QI) program performed in two community oncology systems. For demographics, molecular testing, disease characteristics, treatment history, and shared decision-making, they assessed retrospective EMR audits of 100 patients with ALK or ROS1+ NSCLC. In using molecular tests to guide treatment and correctly sequencing targeted therapies, a high confidence was indicated by 64% of healthcare professionals, though efficient integration of guideline-aligned testing into practice was shown to be challenging, based on the EMR audit. Some patients were not getting frontline targeted therapies, and delays in receiving molecular testing results could be presenting challenges in aligning treatment practices to guidelines. Also, use of distress screening (37%), tobacco counseling (38%), quality of life screening (60%), and engagement/documentation of several aspects of shared decision-making for patient-centered care was sub-optimal, as also indicated by EMR audits. Among those who completed the survey, the routine use of tools to detect patients affected by stigma was indicated by only 59%, which is interesting given the role internalized stigma can play in lung cancer. Overall, essential performance gaps in affording targeted as well as patient-centered treatment for NSCLC in community settings are demonstrated by these observations. These data may hold relevance for future QI programs.