Impact of Reflex EGFR/ALK Testing on Time to Treatment of Patients With Advanced Nonsquamous Non–Small-Cell Lung Cancer

Abstract

Reflex testing of EGFR/ ALK improved the time to optimal systemic therapy and the quality of biomarker testing for patients with advanced nonsq NSCLC.

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

“…Our study demonstrated that, for multiple centres, implementation of reflex testing was associated with an increase in EGFR tests, which is consistent with reports from two single-institution studies 13,18 . Our analysis also found an increase in testing over time, which suggests improved knowledge translation of data supporting EGFR testing; however, that pre-existing trend did not statistically account for the sudden rise and sustained increase in test requests observed after the implementation of reflex testing.…”

“…The proportional increase in EGFR test requests made by pathologists compared with medical oncologists supports the success of the Ontario centres in implementing their centre-specific protocols; however, our study cannot determine if that change resulted in EGFR results being available earlier for treatment decisions by medical oncologists. However, a previous report from the shsc found that reflex testing increased the proportion of patients whose biomarker results were available to medical oncologists at the time of first consultation and lowered the time to optimal first-line treatment for patients with advanced nonsquamous nsclc 13 . Reflex testing did not altogether eliminate EGFR test requests from medical oncologists, indicating that room for improvement in centre protocols remains.…”

“…Earlier receipt of biomarker results by medical oncologists has been shown to significantly improve timeto-treatment decisions and treatment for patients with advanced nonsquamous nsclc 12,13 . Thus, in an effort to improve timely access to EGFR test results, a few centres in Ontario adopted centre-specific protocols for reflex EGFR mutation testing.…”

Epidermal growth factor receptor and anaplastic lymphoma kinase testing and mutation prevalence in patients with advanced non-small cell lung cancer in Switzerland: A comprehensive evaluation of real world practices

“…In our observational study, as expected according to results of randomised trials (Mok et al, 2009;Shaw et al, 2013) T A B L E 4 Relation between ALK status and clinicopathologic features in patients with advanced non-squamous NSCLC According to previous studies long turnaround times for test results were one of the main barriers to EGFR testing as oncologists and patients were both anxious of clinical deterioration during that time (Spicer, Tischer, & Peters, 2015). Although higher testing rates and shorter time to-treatment decisions and treatment can be achieved with reflex testing (Cheema et al, 2015(Cheema et al, , 2017Lim et al, 2015), a…”

Standardizing Biomarker Testing for Canadian Patients with Advanced Lung Cancer

“…Reflex testing is molecular testing that is initiated when the results of a biopsy indicate that lung cancer is present, regardless of cancer staging status. This process has been reported to reduce time to treatment in lung cancer patients 88,89 . In view of the fact that the five-year survival in early-stage lung cancer (localized tumour) is only about 56% 90 , nearly half of these patients would die within five years and tumour progression would occur before the patients' death.…”