scholarly journals Clinical Use of Epidermal Growth Factor Receptor Testing in Patients With Advanced Lung Cancer by Physicians: Survey of US and International Patterns

2019 ◽  
pp. 1-7
Author(s):  
Matthew Peters ◽  
Edward S. Kim ◽  
Vera Hirsch
Keyword(s):  
Lung Cancer ◽  
Egfr Mutation ◽  
Performance Status ◽  
Poor Performance ◽  
Turnaround Time ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

PURPOSE Guidelines recommend testing for EGFR mutation at diagnosis of advanced non–small-cell lung cancer to guide treatment. Two surveys, 18 months apart, aimed to identify changes in EGFR mutation testing and treatment practices in non–small-cell lung cancer. METHODS The first survey of 562 physicians from Canada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, the United Kingdom, and the United States was conducted between December 2014 and January 2015. The second, between July and August 2016, surveyed 707 physicians in the same countries with the addition of China; China was excluded from year-on-year comparisons. RESULTS Globally (excluding China), physicians requested EGFR mutation testing in 80% (excluding China; 2015: 81%) of patients before first-line therapy. In 2016, 18% of results were not received before initiating treatment, a significant improvement over 2015 (23%). Reasons for not testing included tumor histology, insufficient tissue, poor performance status, and long turnaround time, although this had significantly improved in 2016 from 2015. Prolonging of survival/extending life was deemed the most important therapy goal in first-line treatment of both cohorts. CONCLUSION Improvements in availability of test results before first-line therapy were seen, but incomplete implementation of guidelines is still observed, resulting in a large proportion of patients not receiving tyrosine kinase inhibitor treatment on the basis of mutation status. The reasons for not testing remained the same, year-on-year: tumor histology, insufficient tissue, poor performance status, and long test turnaround time. Receiving timely results must be addressed, if treatment parity for eligible patients can be achieved. Physician education and closer guideline concordance are key steps to improve outcomes.

scholarly journals Duration of treatment among patients prescribed afatinib or erlotinib as first-line therapy for EGFR mutation-positive non-small-cell lung cancer in the USA

2019 ◽  
Vol 15 (13) ◽  
pp. 1493-1504 ◽  
Author(s):  
Jonathan Lim ◽  
Carl Samuelsen ◽  
Amanda Golembesky ◽  
Sulena Shrestha ◽  
Li Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Egfr Mutation ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Duration Of Treatment ◽  
First Line Therapy ◽  
Line Therapy ◽  
The Usa

Comparison of clinical outcome between gefitinib and erlotinib treatment in patients with non-small cell lung cancer harboring an epidermal growth factor receptor exon 19 or exon 21 mutations.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19051-e19051
Author(s):  
Sung Hee Lim ◽  
Ji Yoon Lee ◽  
Jong-Mu Sun ◽  
Jin Seok Ahn ◽  
Keunchil Park ◽  
...  
Keyword(s):  
Egfr Mutation ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Ecog Performance Status ◽  
First Line Therapy ◽  
Line Therapy ◽  
Significant Difference ◽  
Egfr Tki

e19051 Background: Gefitinib and erlotinib are small-molecule kinase inhibitors that inhibit signaling via EGFR and both agents showed dramatic response rate and prolonged PFS in patients harboring activating EGFR mutation. We investigated the clinical outcomes between gefitinib- and erlotinib-treated patients with recurrent or metastatic non-small cell lung cancer (NSCLC) harboring EGFR mutations. Methods: A total 375 patients with recurrent or metastatic NSCLC who had either an exon 19 deletion or L858R mutation on exon 21 and received gefitinib (n=228) or erlotinib (n=147) therapy between August 2007 and December 2011 were retrospectively reviewed. By using a matched-pair case-control study design, 121 pairs of gefitinib-treated and erlotinib-treated patients were matched according to sex, smoking history, ECOG performance status, and types of EGFR mutation. Results: The median age of all patients was 58 years (range, 30-84) and more than half of patients were never smokers (63.6%). Most patients had adenocarcinoma (98.3%) and good ECOG performance status (0, 1) (90.9%). Of 242 patients, 64 (26.4%) received an EGFR TKI as first line therapy. The overall response rates and disease control rates in the gefitinib-treated and erlotinib-treated groups were 85.5% versus 79.8 % (p=.375) and 94.0% versus 89.1%, respectively (p=.242). There was no statistically significant difference noted with regard to OS (median, 38.9 vs 37.5; p=.642) and PFS (median, 12.9 vs 10.1; p=.135) between the gefitinib-treated and erlotinib-treated groups. For a subgroup which patients were treated with TKI as first line therapy, the overall response rates were higher than those of patients who had progressed on prior chemotherapy (90.3% vs 79.9%; p=.063). However, there was no significant difference in PFS (median, 13.3 vs 10.3; p=.134) between subjects with first line TKI therapy and more than second line treatment. Conclusions: Both gefitinib and erlotinib showed similar effective activity in selected population of NSCLC that harbored an EGFR mutation and further studies are needed to evaluate the efficacy of EGFR TKI as first line treatment.

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