PCN188 - Emergent Therapies And Egfr Mutation Testing In Non-Small Cell Lung Cancer: Real-World Practices

Abstract

This study aims to characterize the utilization of epidermal growth factor receptor (EGFR) mutation testing and tyrosine kinase inhibitor (TKI) prescribing practices in a population of non-small cell lung cancer (NSCLC) patients at a large hospital in Central Texas. A cohort of newly diagnosed NSCLC patients was identified from the hospital’s cancer registry from 2014 through 2015. The diagnosis date served as the index date for each patient with the follow-up period consisting of one year after the index date. Baseline patient and tumor data were obtained from the cancer registry. During the follow-up period, the utilization of EGFR mutation testing and prescribing of TKIs were obtained from the electronic medical record. Descriptive statistics were performed. There were 617 patients with newly diagnosed NSCLC from 2014 through 2015 and 242 had Stage IV disease. Of those with Stage IV disease, 58% had adenocarcinoma with an additional 19% with unspecified histology. Out of all EGFR mutation testing completed within 40 days of diagnosis, 55% were conducted in non-Stage IV disease. Of patients with Stage IV adenocarcinomas, 68% were tested for EGFR mutations within 40 days of diagnosis. Of that group, 25 patients were then positive for EGFR and 23 were placed on TKI therapy (90% erlotinib and 10% afatinib). This study provides preliminary data in the testing and treatment of EGFR positive NSCLC. Due to limitations in electronic medical record data, the rate of testing may be underestimated. Despite this limitation, these results indicate a gap between actual testing patterns and guideline recommended testing algorithms.