Utilisation and Determinants of Epidermal Growth Factor Receptor Mutation Testing in Patients with Non-small Cell Lung Cancer in Routine Clinical Practice: A Global Systematic Review

Thi, Aye Myat; Tin, Sandar Tin; McKeage, Mark J.; Elwood, J. Mark

doi:10.1007/s11523-020-00718-w

Cited by 16 publications

(9 citation statements)

References 49 publications

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“…As expected, testing was higher for Asians, never-smokers, women, and patients with adenocarcinoma compared with their respective counterparts. 13 , 14 These findings suggest that more patients with EGFR mutations may be identified if EGFR testing rates were to increase in men, smokers, and non-Asians. The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines) specify that clinicopathologic features such as smoking status, ethnicity, and tumor histology should not be used in selecting patients for EGFR biomarker testing.…”

Section: Discussionmentioning

confidence: 96%

EGFR Testing Patterns and Detection of EGFR Exon 20 Insertions in the United States

Lin

Yang

Crossland

et al. 2022

JTO Clinical and Research Reports

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Section: Discussionmentioning

confidence: 96%

EGFR Testing Patterns and Detection of EGFR Exon 20 Insertions in the United States

Lin

Yang

Crossland

et al. 2022

JTO Clinical and Research Reports

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“…Every population-based study of EGFR mutation testing has shown incomplete testing [ 41 ]. Evidence showed that testing tends to be selective due to multiple reasons, including limited testing facilities, high costs and insufficient tissue samples [ 17 , 18 , 41 – 43 ]. Patients with a higher chance of EGFR mutation positivity were therefore more likely to be offered testing, resulting in high EGFR mutation-positive proportions in the tested proportion.…”

Section: Discussionmentioning

confidence: 99%

Population-based incidence rates and increased risk of EGFR mutated non-small cell lung cancer in Māori and Pacifica in New Zealand

et al. 2021

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Background Non-squamous non-small cell lung cancer (NSCLC) patients with Epidermal Growth Factor Receptor (EGFR) mutation benefit from targeted treatments. Previous studies reported EGFR mutation-positive proportions among tested non-squamous NSCLC patients. However, incidence rates and population risk of EGFR mutation-positive and EGFR mutation-negative non-squamous NSCLC have not been assessed. This study therefore aimed to estimate the population-based incidence rates of EGFR mutation-positive and EGFR mutation-negative non-squamous NSCLC in different population groups defined by sex, ethnic group and smoking status. Methods This study included data from all non-squamous NSCLC patients diagnosed in northern New Zealand between 1/02/2010 and 31/07/2017 (N = 3815), obtained from a population-based cancer registry. Age-specific incidence rates, WHO age-standardised rates (ASRs) and rates adjusted for incomplete testing were calculated for EGFR mutation-positive and EGFR mutation-negative diseases for the study cohort as a whole and subgroups of patients. Results Among 3815 patients, 45% were tested for EGFR mutations; 22.5% of those tested were EGFR mutation-positive. The ASR of EGFR mutation-positive NSCLC was 5.05 (95%CI 4.71–5.39) per 100,000 person-years. ASRs for EGFR mutation-positive NSCLC were higher for females than males: standardised incidence ratio (SIR) 1.50 (1.31–1.73); higher for Pacifica, Asians and Māori compared with New Zealand Europeans: SIRs 3.47 (2.48–4.85), 3.35 (2.62–4.28), and 2.02 (1.43–2.87), respectively; and, only slightly increased in ever-smokers compared with never-smokers: SIR 1.25 (1.02–1.53). In contrast, the ASR of EGFR mutation-negative NSCLC was 17.39 (16.75–18.02) per 100,000 person-years, showing a strong association with smoking; was higher for men; highest for Māori, followed by Pacifica and then New Zealand Europeans, and lowest for Asians. When corrected for incomplete testing, SIRs by sex, ethnicity and smoking, for both diseases, remained similar to those based on tested patients. Conclusion The population risk of EGFR mutation-positive NSCLC was significantly higher for Māori and Pacifica compared with New Zealand Europeans.

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“…In patients without adenocarcinoma histology, clinical features such as younger age and no history of tobacco exposure may indicate a higher likelihood of alterations in oncogenic drivers; molecular testing in these patients would therefore be appropriate [5]. Despite the strong rationale for molecular testing in the advanced NSCLC population, surveys of real-world practice suggest that implementation rates are variable [7][8][9][10][11][12][13]. In a recent large global survey by the International Association for the Study of Lung Cancer (IASLC), 89% of respondents requested molecular testing for lung cancer with adenocarcinoma histology, though the majority believed that < 50% of patients with lung cancer (type unspecified) in their country received molecular testing [11].…”

Section: Introductionmentioning

confidence: 99%

“…In a recent large global survey by the International Association for the Study of Lung Cancer (IASLC), 89% of respondents requested molecular testing for lung cancer with adenocarcinoma histology, though the majority believed that < 50% of patients with lung cancer (type unspecified) in their country received molecular testing [11]. Testing rates for EGFR-tyrosine kinase inhibitor (EGFR-TKI) sensitizing mutations, the first actionable mutation to be established for NSCLC, have increased over time, but typically remain below 80% [9][10]12].…”

Section: Introductionmentioning

confidence: 99%

Molecular testing in stage I–III non-small cell lung cancer: Approaches and challenges

et al. 2021

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Utilisation and Determinants of Epidermal Growth Factor Receptor Mutation Testing in Patients with Non-small Cell Lung Cancer in Routine Clinical Practice: A Global Systematic Review

Cited by 16 publications

References 49 publications

EGFR Testing Patterns and Detection of EGFR Exon 20 Insertions in the United States

EGFR Testing Patterns and Detection of EGFR Exon 20 Insertions in the United States

Population-based incidence rates and increased risk of EGFR mutated non-small cell lung cancer in Māori and Pacifica in New Zealand

Molecular testing in stage I–III non-small cell lung cancer: Approaches and challenges

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