Understanding epidermal growth factor receptor mutation (EGFRm) testing in patients (pts) with non-small cell lung cancer (NSCLC) in a large community oncology network.

9 Background: EGFR TKI therapy improves outcomes in pts with EGFRm+ NSCLC. NCCN guidelines recommend EGFRm testing for pts with NSCLC. Testing patterns and predictors of documented EGFRm testing were studied in a real-world setting. Methods: Adult pts with stage IV NSCLC treated from 1/1/2012 to 8/31/2017, identified from the iKnowMed (US Oncology Network) EHR were analyzed. Rates of documented EGFRm testing were calculated. Multivariable stepwise logistic regression analysis was conducted to identify characteristics associated with documented EGFRm testing. Results: Of 14,461 pts, 59.8% had adenocarcinoma and 17.5% had squamous cell carcinoma. Median age of pts was 69.3 years, 52.3% were male, and 14.6% were non-smokers. Testing rates were ~36% overall, an increase in rates was seen over time: ~30% in 2012 to 41% in 2016 (p < .001). Histology, practice size, and several characteristics were associated with documented EGFRm testing (Table). Conclusions: Testing rates steadily increased over time, but were still low, implying suboptimal/under-documented testing. This analysis presents practice site characteristics to target educational programs to improve testing and/or documentation in community settings. [Table: see text]

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Better Progression-Free Survival in Elderly Patients with Stage IV Lung Adenocarcinoma Harboring Uncommon Epidermal Growth Factor Receptor Mutations Treated with the First-line Tyrosine Kinase Inhibitors

Cancers ◽

10.3390/cancers10110434 ◽

2018 ◽

Vol 10 (11) ◽

pp. 434 ◽

Cited By ~ 4

Author(s):

Ming-Ju Tsai ◽

Jen-Yu Hung ◽

Mei-Hsuan Lee ◽

Chia-Yu Kuo ◽

Yu-Chen Tsai ◽

...

Keyword(s):

Lung Adenocarcinoma ◽

Kinase Inhibitors ◽

Growth Factor Receptor ◽

Stage Iv ◽

Progression Free Survival ◽

Egfr Mutations ◽

First Line ◽

Free Survival ◽

Younger Patients ◽

Epidermal Growth

Patients with lung adenocarcinoma harboring common epidermal growth factor receptor (EGFR) mutations usually have a good response rate (RR) and longer progression-free survival (PFS) to EGFR tyrosine kinase inhibitors (TKIs). However, the treatment efficacy to uncommon EGFR mutations remains controversial. We, therefore, performed a retrospective study, screening 2958 patients. A total of 67 patients with lung adenocarcinoma harboring uncommon EGFR mutations were enrolled and 57 patients with stage IV diseases receiving a first-line EGFR TKI were included for further analyses. The patients were classified into 27 (47%) “a single sensitizing uncommon mutation”, 7 (12%) “multiple sensitizing mutations”, 5 (9%) “a sensitizing mutation and a resistant uncommon mutation”, and 18 (32%) “other resistant uncommon mutations”. No significant difference was noted in PFS or overall survival (OS) between groups. Patients receiving different first-line EGFR TKIs had similar PFS and OS. The elder patients had a significantly poorer performance status than the younger patients but a significantly longer PFS than the younger patients (median PFS: 10.5 vs. 5.5 months, p = 0.0320). In conclusion, this is the first study to identify that elderly patients with stage IV lung adenocarcinoma harboring uncommon EGFR mutation might have a longer PFS. Large-scale prospective studies are mandatory to prove our findings.

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