Abstract 100P
Background
Prevalence of EGFRm in NSCLC is estimated to be approximately 30%, although this varies by country and region. This global survey investigated physician behaviours related to genetic testing patterns in early (I/II/IIIa) and advanced (IIIb/IIIc/IV) stage NSCLC.
Methods
An online physician survey was conducted in Argentina, Belgium, Brazil, India, Netherlands, Russian Federation, Singapore, Switzerland and Turkey (June – Sept 2021), investigating perceptions of EGFR testing patterns, interpretation of test results, testing experiences, and treatment decisions in early and advanced stage NSCLC.
Results
The 338 physicians surveyed (82% oncologists, 96% hospital-based) had a median (IQR) monthly caseload of 10 (5–20) early stage and 20 (10–39) advanced/metastatic stage NSCLC patients. 48% indicated routinely testing for EGFRm at stage I, 42% at stage II, 57% at stage IIIa and 88% at stage IV, with an estimated median 30% of patients tested overall at stage I, 40% at stage II, 70% at stage IIIa, and 100% at stage IV. Reasons for not testing at stage I were ‘testing will occur after progression’ (37%) and ‘no treatment implications in practice’ (31%), while the main reasons for not testing at stage IV were ‘inadequate tissue’ (52%) and ‘reimbursement issues’ (32%). Regarding the timing of tests, physicians reported testing for EGFRm before treatment selection in a median 30% of early stage and 90% of advanced patients. 72% and 57% of physicians reported at least ‘sometimes’ initiating treatment prior to receiving EGFR test results in early and advanced stage patients, respectively. Of physicians who initiate treatment prior to receiving test results, ‘risk of disease progression’ was the leading reason in both early (23%) and advanced stage (27%) disease.
Conclusions
EGFRm testing at advanced stage was reported to be standard practice. Most physicians reported not routinely testing for EGFRm at stage I, but testing doubled at stage IIIA. In the early stage setting, not testing was primarily due to a lack of reimbursed targeted treatment options prior to advanced disease. With the introduction of targeted therapy in the early stage disease setting, there is a need to adopt early EGFRm testing to support clinical decision making.
Editorial acknowledgement
Medical writing and editorial support under the guidance of the authors was provided by Gary Sidgwick of Adelphi Real World, Bollington, UK.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
T. Bailey: Financial Interests, Institutional, Sponsor/Funding: AstraZeneca. F. Moiseenko: Financial Interests, Personal, Other, Consulting fees, Honoaria, Advisory board: AstraZeneca; Financial Interests, Personal, Other, Consulting Fees, Honoraria, Advisory board: Boehringer Ingelheim; Financial Interests, Personal, Other, Honoraria, support for attending meetings: Takeda; Financial Interests, Personal, Other, Honoraria: Eli Lilly; Financial Interests, Personal, Other, Honoraria, Patents planned, issued of pending, Advisory board, Other: Bristol Myers Squibb; Financial Interests, Personal, Other, Honoraria, Patents planned, issued or pending, Advisory board, Other: Roche; Financial Interests, Personal, Other, Consulting fees: Pfizer; Financial Interests, Personal, Other, Consulting fees: Sanofi; Financial Interests, Personal, Other, Other: Merck Sharp and Dohme. M.S. Paats: Financial Interests, Institutional, Other, Consulting fees: AstraZeneca; Financial Interests, Institutional, Other, Consulting Fees: Bayer; Financial Interests, Institutional, Other, Consulting Fees: Eli Lilly; Financial Interests, Institutional, Other, Consultancy Fees: Novartis; Financial Interests, Institutional, Other, Consultancy Fees: Pfizer; Financial Interests, Institutional, Other, Consultancy Fees: Roche; Financial Interests, Institutional, Other, Consultancy Fees: Tadeka; Financial Interests, Institutional, Speaker’s Bureau: AstraZeneca; Financial Interests, Institutional, Speaker’s Bureau: Bayer; Financial Interests, Institutional, Speaker’s Bureau: Ely Lilly; Financial Interests, Institutional, Speaker’s Bureau: Novartis; Financial Interests, Institutional, Speaker’s Bureau: Pfizer; Financial Interests, Institutional, Speaker’s Bureau: Roche; Financial Interests, Institutional, Speaker’s Bureau: Tadeka. I. Demedts: Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Merck Sharp and Dohme; Financial Interests, Personal, Advisory Board: Roche. M. Erman: Financial Interests, Institutional, Other, Consulting fees: Abdi Ibrahim; Financial Interests, Institutional, Other, Consulting Fees: Deva; Financial Interests, Institutional, Speaker’s Bureau: Pfizer; Financial Interests, Institutional, Speaker’s Bureau: Merck Sharp and Dohme; Financial Interests, Institutional, Speaker’s Bureau: Roche; Financial Interests, Institutional, Speaker’s Bureau: Astellas; Financial Interests, Institutional, Speaker’s Bureau: Janssen; Financial Interests, Institutional, Speaker’s Bureau: Novartis; Financial Interests, Institutional, Speaker’s Bureau: Gen; Financial Interests, Institutional, Speaker’s Bureau: Nobel; Financial Interests, Institutional, Speaker’s Bureau: Deva; Financial Interests, Institutional, Speaker’s Bureau: Gensenta; Financial Interests, Institutional, Speaker’s Bureau: Bristol Myers Squibb; Financial Interests, Institutional, Speaker’s Bureau: Tadeka; Financial Interests, Institutional, Speaker’s Bureau: AstraZeneca. D.A. Kahangire: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. M. Mark: Financial Interests, Institutional, Advisory Role: Bristol Myers Squibb; Financial Interests, Personal, Advisory Role: Roche; Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Merck Sharp & Dohme. J. Minatta: Financial Interests, Institutional, Research Grant: Pfizer; Financial Interests, Personal, Speaker’s Bureau: Pfizer; Financial Interests, Personal, Speaker’s Bureau: Tadeka; Financial Interests, Personal, Speaker’s Bureau: Merck Sharp & Dohme; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme. S. Rajappa: Financial Interests, Personal, Other, Consulting fees: AstraZeneca; Financial Interests, Personal, Other, Consulting Fees: Pfizer; Financial Interests, Personal, Other, Consulting Fees: Novartis; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca; Financial Interests, Personal, Speaker’s Bureau: Pfizer; Financial Interests, Personal, Speaker’s Bureau: Novartis. M. Madondo: Financial Interests, Personal, Full or part-time Employment: AstraZeneca. A. Taylor: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Full or part-time Employment: Gilead Sciences; Financial Interests, Personal, Stocks/Shares: AstraZeneca; Financial Interests, Personal, Stocks/Shares: Gilead Sciences. J. Samol: Financial Interests, Personal, Research Grant: AstraZeneca; Financial Interests, Personal, Speaker’s Bureau: AstraZeneca; Financial Interests, Personal, Other, Travel support for attending meetings: Roche; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Merck Sharp and Dohme; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Taiho; Financial Interests, Personal, Advisory Board: Ipsen. All other authors have declared no conflicts of interest.