According to a recent study recently presented at the European Lung Cancer Conference, one in every four patients with advanced Lung Cancer in the United States, Asia & Europe is not receiving EGFR test results prior to the start of their treatment — a situation that may impact patient treatment decisions. A team of researchers from King’s College London at Guy’s Hospital in London, UK, led by Dr. James Spice, Medical Oncologist, assessed how hospitals usually conduct the EGFR among lung cancer patients.
According to a recent news release, Dr. Spice said that targeted treatments could be more effective in the treatment of cancers with known genetic mutations. However, Dr. Spice indicated that to conduct the tests needed for targeted treatments, it is necessary to accurately assess the patient’s status.
“The arrival of a new group of targeted EGFR inhibitors for the treatment of lung cancer driven by mutations in the EGFR gene has brought with it a new requirement for diagnostic laboratories to implement genetic testing,” he explained in the news release. “For many institutions this has represented a significant departure from traditional pathology, which had previously focused only on microscopic examinations of tumour tissue.”
“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, particularly the adoption of new treatment approaches in newly diagnosed patients, and these changes have been adopted with variable speed around the world.”
All patients with non-squamous non-small cell lung cancer should have the EGFR tests conducted in a timely manner to avoid delays in first line treatment options, according to the researchers.
In a recent study conducted between December 2014 and January 2015, Dr. Spice and his colleagues assessed via online survey, a total of 562 oncologists across 10 countries (France, Canada, Italy, Japan, Germany, Spain, South Korea, UK, Taiwan and USA).
“We found that globally almost one in four patients are tested but results are not available at the time the treatment decision is made,” Dr. Spice said in the new release. “Not only were some suitable patients not tested at all for tumour EGFR mutations, some patients did undergo testing, but the treatment decision about whether to give an EGFR inhibitor or chemotherapy as first line treatment was taken without reference to the result.”
According to Dr. Spice, some patients were affected in their treatment outcomes because they did not undergo the test. “Indeed, some recent clinical trial evidence suggests that this may even be compromising access to treatment that is associated with an overall survival benefit.”
Professor Silvia Novello from the Department of Oncology at the University of Turin, Italy commented that one of the major strengths of this study was the fact that is was international. She mentioned that the study authors were able to show that EGFR test was requested in 81% of the patients with stage IIIb/IV non-small cell lung cancer before initiation of first line therapy. EGFR Test results were found to be available before treatment administration in 77% of cases.
She also said that the fact that this was a survey study and not an observational study limits interpretation of results.
Oncologists that responded to the survey mentioned that among the reasons for non-testing EGFR were a long turn-around time for testing, poor performance status of the patient and a lack of sufficient tissue “The first two reasons are partially related to an incomplete integration of multidisciplinary oncology teams, while the third one can be attributed to an imperfect knowledge of data regarding the use of EGFR inhibitors,” Professor Novello concluded in the news release.