Several therapies targeting molecular alterations in subgroups of NSCLC patients (pts) have been approved and require pts to be tested for these targets. Thorough knowledge of the diagnostic and therapeutic algorithm in routine practice is crucial to evaluate and improve the quality of care.
The prospective, national clinical research platform CRISP recruits pts in currently 149 representative cancer centres in all therapeutic sectors in Germany. Up to 8000 pts will be recruited and followed until death or up to a maximum of 3 years, respectively. Data from 823 pts recruited by 89 centers by June 30th, 2017 was analysed regarding molecular testing. An update with data cut June 30th, 2018 including at least 2.000 pts by 130 centres will be presented at the conference.
Median age was 67 years and 61% of pts were male. 12% of pts were never smokers. 79% of pts had non-squamous carcinoma (nsqc), 21% squamous carcinoma (sqc). Overall 84% (nsqc 92%, sqc 52%) of pts were tested with at least one test method at the start of treatment. Median turn around time was 2 weeks for next generation sequencing (NGS), 10 days for FISH and one week for other sequencing and IHC. In pts with nsqc (n = 653) 32% of pts were tested by NGS, 45% by other sequencing and 49% by IHC and 38% by FISH. Molecular test rates for EGFR, ALK , and ROS-1 were 73%, 70%, and 53% respectively. In pts with sqc (n = 170) 12% of pts were tested by NGS, 11% by other sequencing, 34% by IHC and 10% by FISH. Molecular test rates for EGFR, ALK, and ROS-1 were 23%, 21%, and 15%, respectively. Test rates for PD-L1 increased from 23% in 2016 to 48% in the first half of 2017. For pts with nsqc for whom test results were available at time of analysis, an EGFR alteration was detected in 15% (n = 71), an ALK alteration in 8% (n = 37), and a ROS-1 alteration in 3% (n = 10) of pts. 24% (n = 65) of pts for whom PD-L1 tumour proportion score (TPS) results were available had a TPS ≥50%.
CRISP presents current real life data on molecular testing from all treatment sectors in Germany. Pts are frequently tested for molecular alterations. NGS is used in one third of nsqc pts. Reasons for testing / non-testing and changes over time will be discussed based on the 2018 data cut.
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Legal entity responsible for the study
CRISP is supported by AstraZeneca GmbH, Boehringer Ingelheim Pharma GmbH & Co. KG, Bristol-Myers Squibb GmbH & Co. KGaA, Celgene GmbH, Lilly Deutschland GmbH, MSD SHARP & DOHME GmbH, Novartis Pharma GmbH, Pfizer Pharma GmbH, Roche Pharma AG and Takeda Pharma Vertrieb GmbH & Co.KG.
All authors have declared no conflicts of interest.