Abstract
Epidermal growth factor receptor (EGFR) genotyping, a critical examen for the treatment decisions of patients with non-small cell lung cancer (NSCLC), is commonly assayed by next-generation sequencing (NGS), but this global approach takes time. To determine whether rapid EGFR genotyping tests by the IdyllaTM system guides earlier therapy decisions, EGFR mutations were assayed by both the IdyllaTM system and NGS in 223 patients with NSCLC in a bicentric prospective study. IdyllaTM demonstrated agreement with the NGS method in 187/194 cases (96.4%) and recovered 20 of the 26 (77%) EGFR mutations detected using NGS. Regarding the seven missed EGFR mutations, five were not detected by the IdyllaTM system, one was assayed in a sample with insufficient tumoral cells, and the last was in a sample not validated by the IdyllaTM system (a bone metastasis). IdyllaTM did not detect any false positives. The average time between EGFR genotyping results from IdyllaTM and the NGS method was 9.2 ± 2.2 working days (wd) (12.6 ± 4.0 calendar days (cd)). Subsequently, based on the IdyllaTM method, the timeframe from tumor sampling to the initiation of EGFR-TKI was 7.7 ± 1.2 wd (11.4 ± 3.1 cd), while it was 20.3 ± 6.7 wd (27.2 ± 8.3 cd) with the NGS method (p < 0.001). We thus demonstrated here that the IdyllaTM system contributes to improving the therapeutic care of patients with NSCLC by the early screening of EGFR mutations.
Highlights
Lung carcinoma remains the most common cause of cancer death worldwide
Surgery is insufficient for the therapeutic care of these patients, who can benefit from chemotherapy based on platinum salts, immunotherapy according to the tumor expression of PDL1, or targeted therapy depending on the molecular abnormalities detected in their tumor
IdyllaTM system and nextgeneration sequencing (NGS) genotyping for Epidermal growth factor receptor (EGFR)
Summary
85% of lung cancers are non-small cell lung cancer (NSCLC), and 15% are small cell lung cancer (SCLC). The prognosis of patients with NSCLC remains poor, with a five-year survival rate of 15%, NSCLC being most often diagnosed at an advanced Surgery is insufficient for the therapeutic care of these patients, who can benefit from chemotherapy based on platinum salts, immunotherapy according to the tumor expression of PDL1 (programmed death-ligand 1), or targeted therapy depending on the molecular abnormalities detected in their tumor. PD-1 blockade alone or with platinum-based chemotherapy is the first-line therapy (depending on the level of PDL1 expression) for non-targetable metastatic NSCLC, while never-smoking patients with NSCLC more often harbor a targetable molecular aberration
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