EGFR Point of Care Clinical Testing using Idylla Platform Decreases Laboratory Turnaround Time in Advanced Stage Non-Small Cell Lung Cancer, as Compared to New Generation Sequencing

Abstract

"Background: Patients with advanced-stage non-small cell lung cancer (NSCLC) benefit from a short time-to-treatment (TTT) due to disease severity. Patients at BC Cancer with NSCLC undergo OncoPanel testing, a next-generation sequencing assay, for potential oncogenic drivers prior to treatment as outlined by CAP-AMP-IASLC guidelines. Genetic testing via OncoPanel takes more than two weeks and commonly contributes to an increased TTT. The novel ultra-rapid Idylla EGFR testing platform may decrease TTT in patients who are EGFR mutation positive (M+) due to the mutual exclusivity of actionable mutations. This study evaluates the lab turnaround time (TAT) of the Idylla EGFR testing platform and compares it to that of the OncoPanel. Methods: A group of patients (N = 235) with stage IIIB or stage IV lung adenocarcinoma diagnosed between November 1, 2020 and May 1, 2021 had both OncoPanel and Idylla EGFR testing. The time at which the sample was received in the lab, the time of Idylla EGFR test reporting, and the time of OncoPanel reporting were recorded for each patient. Differences in the lab TAT between the OncoPanel and Idylla EGFR test were compared using a paired t-test within the cohort. Results: The mean lab TAT for the Idylla and OncoPanel tests were 3.4 days (Range: 0-8 days) and 15.8 days (Range: 12-31 days), respectively. It was observed that the lab TAT of the Idylla EGFR test was faster by an average of 12.4 days (Range: 6-29 days, p<0.01, 95% CI: [11.9, 12.8] days) than the OncoPanel TAT (N=235). Conclusions: The lab TAT of the Idylla EGFR test is significantly shorter than of OncoPanel testing. In patients who are EGFR M+, molecular testing could be completed considerably faster using the Idylla EGFR testing platform since further genetic testing is unlikely to yield additional actionable information. Using the Idylla EGFR test as part of a reflexive molecular testing repertoire in advanced-stage NSCLC patients could thus reduce patient TTT."