EGFR Mutation Testing and Oncologist Treatment Choice in Advanced Nsclc: Global Trends and Differences

Spicer, James; Tischer, Bernd; Peters, Matthew

doi:10.1093/annonc/mdv128.04

Cited by 43 publications

(39 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Targeted agents were prescribed for 24 patients with lung cancer, only 13 of whom had an EGFR mutation. This finding is not unusual and corroborates results of a recent survey of 562 oncologists in 10 countries, showing that one in four patients with advanced lung cancer did not have EGFR-TK test results available before starting targeted treatment [19]. For those patients who were EGFR-TK+, oncologists estimated benefits from treatment that ranged from 20 to 80% of patients in general; suggesting widely differing views.…”

Section: Discussionsupporting

confidence: 83%

Therapeutic aims of drugs offering only progression-free survival are misunderstood by patients, and oncologists may be overly optimistic about likely benefits

Fallowfield

Catt

May

et al. 2016

Support Care Cancer

View full text Add to dashboard Cite

Purpose: The use of novel and often expensive drugs offering limited survival benefit in advanced disease is controversial. Treatment recommendations are influenced by patient characteristics and trial data showing overall response rates (ORR), Progression Free Survival (PFS) and Overall Survival (OS). PFS is frequently the primary outcome in licensing studies. Patients and methods:As part of a longitudinal study Assessing the 'VALue' to patients of PROgression Free Survival (AVALPROFS), oncologists completed checklists at baseline following consultations with patients. Questions probed perceived clinical benefits of the drugs to populations in general. Patients completed study specific interview schedules at baseline, 6 weeks into treatment, and at withdrawal due to toxicity or progression. Patients also completed tumour and treatment specific quality of life questionnaires monthly for their time in the study. Only baseline results are reported here.Results: 32 UK oncologists discussed management options with 90 patients with heterogeneous advanced cancers. Oncologists' estimates of medical benefit in general from treatment varied between 10-80%. They expected 46/90 (51%) of their patients to derive some clinical benefit from the prescribed treatment but were either unsure or expected none for 44/90 (49%). Predictions of life expectancy were variable but 62% (56/90) of patients were expected to survive longer with treatment. A majority of patients 51/90 (57%) had 'no idea' or were 'unclear' what PFS meant and 45/90 (50%) thought extension of life was the primary therapeutic aim of treatment. Conclusion:Discussions between doctors and patients with metastatic disease about future management plans and likely therapeutic gains are challenging. Factors influencing decisions about putative benefits of novel drugs are often applied inconsistently can be overly optimistic and may even contradict published data.

show abstract

Section: Discussionsupporting

confidence: 83%

Therapeutic aims of drugs offering only progression-free survival are misunderstood by patients, and oncologists may be overly optimistic about likely benefits

Fallowfield

Catt

May

et al. 2016

Support Care Cancer

View full text Add to dashboard Cite

show abstract

“…Although geographic differences persist, it is estimated that at least 75% of patients with advanced-stage lung AD or NSCLC-NOS are currently being tested for EGFR mutations [33], which represents significant progress since the 2013 CAP/ IASLC/AMP guidelines were introduced [5]. These guidelines are undergoing revision to align more closely with the NCCN guidelines, which also recommend testing for five additional genes.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Genomic Profiling Facilitates Implementation of the National Comprehensive Cancer Network Guidelines for Lung Cancer Biomarker Testing and Identifies Patients Who May Benefit From Enrollment in Mechanism-Driven Clinical Trials

Suh¹,

Johnson²,

Albacker³

et al. 2016

The Oncologist

View full text Add to dashboard Cite

Background. The National Comprehensive Cancer Network (NCCN) guidelines for patients with metastatic non-small cell lung cancer (NSCLC) recommend testing for EGFR, BRAF, ERBB2, and MET mutations; ALK, ROS1, and RET rearrangements; and MET amplification. We investigated the feasibility and utility of comprehensive genomic profiling (CGP), a hybrid capture-based next-generation sequencing (NGS) test, in clinical practice. Methods. CGP was performed to a mean coverage depth of 5763 on 6,832 consecutive cases of NSCLC (2012)(2013)(2014)(2015). Genomic alterations (GAs) (point mutations, small indels, copy number changes, and rearrangements) involving EGFR, ALK, BRAF, ERBB2, MET, ROS1, RET, and KRAS were recorded. We also evaluated lung adenocarcinoma (AD) cases without GAs, involving these eight genes. Results. The median age of the patients was 64 years (range: 13-88 years) and 53% were female. Among the patients

show abstract

“…Despite those recommendations, a recent international survey of medical oncologists found that EGFR testing was not performed for 1 in 4 patients with advanced nsclc in North America (24%) 10 . One of the main barriers to EGFR testing identified by medical oncologists was the long turnaround time for results; oncologists and patients were both uncomfortable with delaying therapy because of the risk of clinical deterioration during that time 10 .…”

Section: Introductionmentioning

confidence: 99%

“…One of the main barriers to EGFR testing identified by medical oncologists was the long turnaround time for results; oncologists and patients were both uncomfortable with delaying therapy because of the risk of clinical deterioration during that time 10 . In Canada, the time from initiation of EGFR testing to results was found to be 18 days (range: 15-26 days) 11 .…”

Section: Introductionmentioning

confidence: 99%

Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists

et al. 2017

View full text Add to dashboard Cite

show abstract

EGFR Mutation Testing and Oncologist Treatment Choice in Advanced Nsclc: Global Trends and Differences

Cited by 43 publications

References 0 publications

Therapeutic aims of drugs offering only progression-free survival are misunderstood by patients, and oncologists may be overly optimistic about likely benefits

Therapeutic aims of drugs offering only progression-free survival are misunderstood by patients, and oncologists may be overly optimistic about likely benefits

Comprehensive Genomic Profiling Facilitates Implementation of the National Comprehensive Cancer Network Guidelines for Lung Cancer Biomarker Testing and Identifies Patients Who May Benefit From Enrollment in Mechanism-Driven Clinical Trials

Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists

Contact Info

Product

Resources

About