Nearly one in four patients with advanced lung cancer in Europe, Asia, and the United States are not receiving epidermal growth factor receptor (EGFR) test results before starting treatment, according to an abstract presented at the European Lung Cancer Conference (Switzerland; April 15-18). In some cases, patients aren’t being tested. Sometimes results are not returned before treatment begins. But, some clinicians, worrisomely, are making treatment decisions disregarding test results. “There is incomplete implementation of guidelines for identification and treatment of EGFR mutations in non-small cell lung cancer (NSCLC),”writes lead author James Spicer, M.B., Ph.D., Guy’s & St. Thomas’ Hospital Trust (United Kingdom). While laboratories can directly address some barriers, such as turnaround time, education of oncologists is needed to bring greater “concordance” between practice preferences and guidelines, he says. Guidelines call for EGFR mutation testing prior to initiating treatment of advanced NSCLC due to better outcomes with targeted therapies, such as tyrosine kinase inhibitors. To assess compliance with these guidelines, the researchers surveyed 562 oncologists from 10 countries between December 2014 and January 2015. The researchers found that 81 percent of oncologists report requesting EGFR mutation testing prior to first line therapy in stage IIIb/ IV NSCLC patients. However, 23 […]
Nearly one in four patients with advanced lung cancer in Europe, Asia, and the United States are not receiving epidermal growth factor receptor (EGFR) test results before starting treatment, according to an abstract presented at the European Lung Cancer Conference (Switzerland; April 15-18). In some cases, patients aren’t being tested. Sometimes results are not returned before treatment begins. But, some clinicians, worrisomely, are making treatment decisions disregarding test results.
“There is incomplete implementation of guidelines for identification and treatment of EGFR mutations in non-small cell lung cancer (NSCLC),”writes lead author James Spicer, M.B., Ph.D., Guy’s & St. Thomas’ Hospital Trust (United Kingdom). While laboratories can directly address some barriers, such as turnaround time, education of oncologists is needed to bring greater “concordance” between practice preferences and guidelines, he says.
Guidelines call for EGFR mutation testing prior to initiating treatment of advanced NSCLC due to better outcomes with targeted therapies, such as tyrosine kinase inhibitors. To assess compliance with these guidelines, the researchers surveyed 562 oncologists from 10 countries between December 2014 and January 2015.
The researchers found that 81 percent of oncologists report requesting EGFR mutation testing prior to first line therapy in stage IIIb/ IV NSCLC patients. However, 23 percent of oncologists do not consider EGFR mutation subtypes in making treatment decisions. Mutation test results were available before initiating first line therapy in 77 percent of tested patients, although there were significant differences between countries (51 percent in France to 89 percent in Japan). Insufficient tissue, poor performance status, and long turnaround time were cited as barriers to testing.
“The arrival of a new group of targeted EGFR inhibitors for the treatment of lung cancer ... has brought with it a new requirement for diagnostic laboratories to implement genetic testing,” says Spicer in a statement. “The new skills and investment required to deliver this new molecular pathology have understandably taken time to become universally available. Furthermore, the new clinical data underlying these developments has mandated a change in clinical practice.”
