Clinician Practice Preferences Affect EGFR Testing

Nearly one in four patients with advanced lung cancer in Europe, Asia, and the United States are not receiving epidermal growth factor receptor (EGFR) test results before starting treatment, according to an abstract presented at the European Lung Cancer Conference (Switzerland; April 15-18). In some cases, patients aren’t being tested. Sometimes results are not returned before treatment begins. But, some clinicians, worrisomely, are making treatment decisions disregarding test results. “There is incomplete implementation of guidelines for identification and treatment of EGFR mutations in non-small cell lung cancer (NSCLC),”writes lead author James Spicer, M.B., Ph.D., Guy’s & St. Thomas’ Hospital Trust (United Kingdom). While laboratories can directly address some barriers, such as turnaround time, education of oncologists is needed to bring greater “concordance” between practice preferences and guidelines, he says. Guidelines call for EGFR mutation testing prior to initiating treatment of advanced NSCLC due to better outcomes with targeted therapies, such as tyrosine kinase inhibitors. To assess compliance with these guidelines, the researchers surveyed 562 oncologists from 10 countries between December 2014 and January 2015. The researchers found that 81 percent of oncologists report requesting EGFR mutation testing prior to first line therapy in stage IIIb/ IV NSCLC patients. However, 23 […]