Abstract 26P
Background
EGFR mutations occur in 10–50% of NSCLC patients globally. EGFR testing is recommended for NSCLC, with EGFR-TKIs recommended as the optimal first-line (1L) treatment for patients with advanced EGFRm NSCLC. This study investigated EGFR testing turnaround time and real-world treatment patterns in patients with advanced EGFRm NSCLC in nine countries.
Methods
A retrospective chart review was conducted from June to September 2021 in Argentina, Belgium, Brazil, India, Netherlands, Russia, Singapore, Switzerland, and Turkey. Overall, 947 case report forms were collected for patients who presented with advanced/metastatic (stage IIIB/C/IV) NSCLC who received a positive first EGFR test result between 01 April 2017–31 March 2018 (index date). Data on demographics, clinical characteristics, EGFR testing, and treatment patterns were abstracted from diagnosis until June 2020 (or death).
Results
Demographics and clinical characteristics are described in the table. Median EGFR test turnaround time was 14 days (Interquartile Range: 10–22). Overall, 69% of patients received a 1L (post-index) EGFR-TKI (48% 1st Generation), 13% received chemotherapy alone, 9% received another regimen, and 9% did not receive any treatment. Median time to first subsequent therapy (TTFST) after initiation of 1L EGFR-TKI was 22.2 months.
Table: 26P| Overall n = 947 | |
|---|---|
| Median age at diagnosis, years (range) | 61.4 (20.0–90.0) |
| Sex, n (%) | |
| Male | 500 (53%) |
| Female | 447 (47%) |
| Smoking status, n (%) | |
| Current smoker | 141 (15%) |
| Ex-smoker | 291 (31%) |
| Never smoked | 393 (41%) |
| EGFR Test performed as single gene test or as part of a panel, n (%) | |
| Single gene test | 606 (64%) |
| Part of a panel | 341 (36%) |
| EGFR Mutation type recorded since diagnosis (most commonly reported), n (%) | |
| Exon 19 deletion | 346 (37%) |
| L858R | 310 (33%) |
| T790M | 115 (12%) |
Conclusions
Median EGFR test turnaround time was longer than the 10 working days recommended by guidelines; suggestive of the need to improve EGFR testing practices to ensure timely initiation of targeted therapy. As this study included dates up until 2020, testing practices may have improved since study end. For patients treated with an EGFR-TKI as 1L therapy, TTFST in this real-world study was favourable. However, 31% of EGFRm patients did not receive a 1L EGFR-TKI. The results suggest an unmet need to optimise treatment strategies for patients with advanced EGFRm NSCLC.
Editorial acknowledgement
We would like to acknowledge Victoria Davis from Adelphi Real World for her medical writing support.
Legal entity responsible for the study
AstraZeneca.
Funding
AstraZeneca.
Disclosure
I. Demedts: Financial Interests, Institutional, Advisory Board, ID declares consultancy fee for advisory board: AstraZeneca. M. Erman: Financial Interests, Institutional, Advisory Board, ME declares taking part in presentations and advisory boards for listed companies: Novartis, Pfizer, Roche, Astellas, MSD, Deva, AstraZeneca, Janssen, Gen, Nobel, Eczacibasi, BMS, Takeda. J.N. Minatta: Financial Interests, Institutional, Funding, Author was an investigator in clinical trials sponsored by companies listed: AstraZeneca, BMS, Janssen, Roche, MSD, GSK; Financial Interests, Personal, Advisory Board, Consulting/ Advisory Board, Educational: MSD, Pfizer, Takeda, Amgen. F.V. Moiseenko: Financial Interests, Personal, Other, FM declares personal fees from listed companies: Pfizer, AstraZeneca, Takeda, Biocad, Novartis, MSD, Roche, BMS, Eli Lilly; Non-Financial Interests, Personal, Other, FM declares non-financial support from listed companies: AstraZeneca, Biocad, Boehringer Ingelheim. T. Bailey: Financial Interests, Institutional, Other, TB is an employee of Adelphi Real World, who have received funding from AstraZeneca for this work: AstraZeneca. H. Wallis: Financial Interests, Institutional, Other, HW is an employee of Adelphi Real World, who have received funding from AstraZeneca for this work: AstraZeneca. M. Madondo: Financial Interests, Institutional, Other, MM is an employee of AstraZeneca: AstraZeneca. D. Kahangire: Financial Interests, Institutional, Other, DK is an employee of AstraZeneca: AstraZeneca. All other authors have declared no conflicts of interest.