Introduction International and UK guidelines recommend EGFR mutation testing should be performed for advanced non-squamous NSCLC and results should guide treatment decisions. This testing is an important component of standard care because matching mutations to specific TKI treatment can extend survival and improve quality of life compared to first-line chemotherapy.
Objectives To assess the prevalence of EGFR mutation testing, attitudes and barriers to testing, and how results affect choice of therapy among prescribers in the UK and internationally.
Methods We conducted an online representative survey of 562 prescribers in 10 countries (Canada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, UK and US) between December 2014 and January 2015, including 51 oncologists in the UK (Annals of Oncology, Volume 26, Supplement 1, 2015).
Results In the UK, prescribers stated that 77% of newly diagnosed patients with advanced NSCLC were tested for EGFR mutations, the same proportion as in Europe (77%) and North America (76%), but less than in Asia (92%). The stated reasons for not testing included: histology, insufficient tissue to perform the test, poor performance status, and long turnaround time for results. Despite the relatively high rate of EGFR testing claimed in the UK, respondents said that 21% of patients for whom a test was ordered were started on first-line treatment before results were available, nearly double the rate in Asia (12%). Further, 67% of UK of oncologists, compared to 51% of all respondents, reported that treatment decisions were not affected by EGFR mutation subtype.
Conclusion Despite the high levels of EGFR mutation testing in the UK, the survey found that more than one in five patients with advanced NSCLC do not receive treatment personalised for cancer type and mutation subtype, even though evidence shows this improves survival and quality of life. These findings suggest there is incomplete implementation of UK guidelines. Further research is needed to discover what factors contribute to oncologists not following established guidelines in the UK. These data were originally presented at the European Lung Cancer Conference, 2015. Annals of Oncology, Volume 26, Supplement 1, 2015.
Reference 1 Spicer J, Tischer B, Peters M. EGFR mutation testing and oncologist treatment choice in advanced NSCLC: global trends and differences. Annals of Oncology 2015;26(supplement 1):i57–i61