Clinical use of epidermal growth factor receptor testing in patients with advanced lung cancer by physicians: survey of US and international patterns

Matthew Peters, Edward S. Kim, Vera Hirsch

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: Guidelines recommend testing for EGFR mutation at diagnosis of advanced non-small-cell lung cancer to guide treatment. Two surveys, 18 months apart, aimed to identify changes in EGFR mutation testing and treatment practices in non-small-cell lung cancer. Methods: The first survey of 562 physicians from Canada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, the United Kingdom, and the United States was conducted between December 2014 and January 2015. The second, between July and August 2016, surveyed 707 physicians in the same countries with the addition of China; China was excluded from year-on-year comparisons. Results: Globally (excluding China), physicians requested EGFR mutation testing in 80% (excluding China; 2015: 81%) of patients before first-line therapy. In 2016, 18% of results were not received before initiating treatment, a significant improvement over 2015 (23%). Reasons for not testing included tumor histology, insufficient tissue, poor performance status, and long turnaround time, although this had significantly improved in 2016 from 2015. Prolonging of survival/extending life was deemed the most important therapy goal in first-line treatment of both cohorts. Conclusion: Improvements in availability of test results before first-line therapy were seen, but incomplete implementation of guidelines is still observed, resulting in a large proportion of patients not receiving tyrosine kinase inhibitor treatment on the basis of mutation status. The reasons for not testing remained the same, year-on-year: tumor histology, insufficient tissue, poor performance status, and long test turnaround time. Receiving timely results must be addressed, if treatment parity for eligible patients can be achieved. Physician education and closer guideline concordance are key steps to improve outcomes.

LanguageEnglish
Pages1-7
Number of pages7
JournalJournal of global oncology
Volume5
Issue number5
Early online date27 Feb 2019
DOIs
Publication statusPublished - 1 Apr 2019

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Epidermal Growth Factor Receptor
Lung Neoplasms
Physicians
China
Mutation
Therapeutics
Guidelines
Non-Small Cell Lung Carcinoma
Histology
Surveys and Questionnaires
Republic of Korea
Parity
Taiwan
Spain
Protein-Tyrosine Kinases
Italy
France
Canada
Germany
Neoplasms

Bibliographical note

Copyright the Publisher 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Cite this

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title = "Clinical use of epidermal growth factor receptor testing in patients with advanced lung cancer by physicians: survey of US and international patterns",
abstract = "Purpose: Guidelines recommend testing for EGFR mutation at diagnosis of advanced non-small-cell lung cancer to guide treatment. Two surveys, 18 months apart, aimed to identify changes in EGFR mutation testing and treatment practices in non-small-cell lung cancer. Methods: The first survey of 562 physicians from Canada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, the United Kingdom, and the United States was conducted between December 2014 and January 2015. The second, between July and August 2016, surveyed 707 physicians in the same countries with the addition of China; China was excluded from year-on-year comparisons. Results: Globally (excluding China), physicians requested EGFR mutation testing in 80{\%} (excluding China; 2015: 81{\%}) of patients before first-line therapy. In 2016, 18{\%} of results were not received before initiating treatment, a significant improvement over 2015 (23{\%}). Reasons for not testing included tumor histology, insufficient tissue, poor performance status, and long turnaround time, although this had significantly improved in 2016 from 2015. Prolonging of survival/extending life was deemed the most important therapy goal in first-line treatment of both cohorts. Conclusion: Improvements in availability of test results before first-line therapy were seen, but incomplete implementation of guidelines is still observed, resulting in a large proportion of patients not receiving tyrosine kinase inhibitor treatment on the basis of mutation status. The reasons for not testing remained the same, year-on-year: tumor histology, insufficient tissue, poor performance status, and long test turnaround time. Receiving timely results must be addressed, if treatment parity for eligible patients can be achieved. Physician education and closer guideline concordance are key steps to improve outcomes.",
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Clinical use of epidermal growth factor receptor testing in patients with advanced lung cancer by physicians : survey of US and international patterns. / Peters, Matthew; Kim, Edward S.; Hirsch, Vera.

In: Journal of global oncology, Vol. 5, No. 5, 01.04.2019, p. 1-7.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Kim,Edward S.

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N1 - Copyright the Publisher 2019. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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N2 - Purpose: Guidelines recommend testing for EGFR mutation at diagnosis of advanced non-small-cell lung cancer to guide treatment. Two surveys, 18 months apart, aimed to identify changes in EGFR mutation testing and treatment practices in non-small-cell lung cancer. Methods: The first survey of 562 physicians from Canada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, the United Kingdom, and the United States was conducted between December 2014 and January 2015. The second, between July and August 2016, surveyed 707 physicians in the same countries with the addition of China; China was excluded from year-on-year comparisons. Results: Globally (excluding China), physicians requested EGFR mutation testing in 80% (excluding China; 2015: 81%) of patients before first-line therapy. In 2016, 18% of results were not received before initiating treatment, a significant improvement over 2015 (23%). Reasons for not testing included tumor histology, insufficient tissue, poor performance status, and long turnaround time, although this had significantly improved in 2016 from 2015. Prolonging of survival/extending life was deemed the most important therapy goal in first-line treatment of both cohorts. Conclusion: Improvements in availability of test results before first-line therapy were seen, but incomplete implementation of guidelines is still observed, resulting in a large proportion of patients not receiving tyrosine kinase inhibitor treatment on the basis of mutation status. The reasons for not testing remained the same, year-on-year: tumor histology, insufficient tissue, poor performance status, and long test turnaround time. Receiving timely results must be addressed, if treatment parity for eligible patients can be achieved. Physician education and closer guideline concordance are key steps to improve outcomes.

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