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The results of a recent survey suggest that nearly a quarter of advanced lung cancer patients fail to receive epidermal growth factor receptor (EGFR) testing before starting treatment.

The recent development of drugs that target EGFR has expanded treatment options and improved the outcome for individuals with lung cancer. Guidelines from the International Association for the Study of Lung Cancer (IASLC) have been developed and they recommend EGFR mutation testing at the time of diagnosis of advanced non-small cell lung cancer (NSCLC) of non-squamous histology and using the results to guide treatment decisions.

In order to evaluate real world trends in EGFR mutation testing, doctors from the UK surveyed 562 oncologists in Canada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, the UK and the U.S. between December 2014 and January 2015.

The survey revealed that EGFR mutation testing was requested prior to first-line therapy in 81% of newly diagnosed stage III-IV NSCLC patients. The main reasons offered for not testing were insufficient tissue, poor performance status and a long turnaround time to get the test results.

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Twenty-three percent of oncologists said they don’t consider EGFR mutation subtypes in making treatment decisions, while 49% said their decision, including specific TKI selection, is affected by the mutation detected.

The results of this survey demonstrate incomplete implementation of the guidelines for identification and treatment of EGFR mutation-positive NSCLC and suggest some patients that could potentially benefit from an EGFR targeted therapy will be denied that opportunity.  Patients with newly diagnosed NSCLC should determine if EGFR testing has been performed on their tissue sample and if not, request it.

Reference: Spicer J, Tischer B, Peters M. EGFR Mutation Testing and Oncologist Treatment Choice in Advanced NSCLC: Global Trends and Differences. Presented at ELCC 2015, abstract number LBA2 PR.

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