Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists
| Autor: | L Zibdawi, J C Victor, Parneet Cheema, R.H. El-Maraghi, A Chan, J Li, S Raphael, A Dolley, Alison Dziarmaga, R McClure |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
medicine.medical_specialty Standard of care business.industry EGFR biomarkers medicine.disease Confidence interval Surgery 03 medical and health sciences 0302 clinical medicine non-small-cell lung cancer Egfr mutation 030220 oncology & carcinogenesis Internal medicine medicine Reflex 030212 general & internal medicine Non small cell business Lung cancer Reflex testing |
| Zdroj: | Current Oncology Volume 24 Issue 1 Pages 3266-22 |
| ISSN: | 1718-7729 |
| Popis: | Testing for mutation of the EGFR (epidermal growth factor receptor) gene is a standard of care for patients with advanced nonsquamous non-small-cell lung cancer (nsclc). To improve timely access to EGFR results, a few centres implemented reflex testing, defined as a request for EGFR testing by the pathologist at the time of a nonsquamous nsclc diagnosis. We evaluated the impact of reflex testing on EGFR testing rates. A retrospective observational review of the Web-based AstraZeneca Canada EGFR Database from 1 April 2010 to 31 March 2014 found centres within Ontario that had requested EGFR testing through the database and that had implemented reflex testing (with at least 2 years&rsquo worth of data, including the pre- and post-implementation period). The 7 included centres had requested EGFR tests for 2214 patients. The proportion of pathologists requesting EGFR tests increased after implementation of reflex testing (53% vs. 4%) conversely, the proportion of medical oncologists requesting tests decreased (46% vs. 95%, p < 0.001). After implementation of reflex testing, the mean number of patients having EGFR testing per centre per month increased significantly [12.6 vs. 4.9 (range: 4.5&ndash 14.9), p < 0.001]. Before reflex testing, EGFR testing rates showed a significant monthly increase over time (1.37 more tests per month 95% confidence interval: 1.19 to 1.55 tests p < 0.001). That trend could not account for the observed increase with reflex testing, because an immediate increase in EGFR test requests was observed with the introduction of reflex testing (p = 0.003), and the overall trend was sustained throughout the post&ndash reflex testing period (p < 0.001). Reflex EGFR testing for patients with nonsquamous nsclc was successfully implemented at multiple centres and was associated with an increase in EGFR testing. |
| Databáze: | OpenAIRE |
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