EGFR Testing Patterns and Detection of EGFR Exon 20 Insertions in the United States

Autor: Huamao M. Lin, PhD, Yu Yin, MS, Victoria Crossland, PhD, Yanyu Wu, PhD, Sai-Hong Ignatius Ou, MD, PhD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: JTO Clinical and Research Reports, Vol 3, Iss 3, Pp 100285- (2022)
Druh dokumentu: article
ISSN: 2666-3643
DOI: 10.1016/j.jtocrr.2022.100285
Popis: Introduction: EGFR exon 20 insertions (EGFRex20ins) are a diverse set of mutations in NSCLC that are refractory to tyrosine kinase inhibitors. We describe real-world EGFRex20ins detection patterns in patients with advanced NSCLC in the United States. Methods: Data from 2011 to 2020 were extracted from the Flatiron Health electronic health record-derived deidentified database. Results: Among 67,281 patients with advanced NSCLC and at least two clinic visits, 66.8% were tested for EGFR mutations, of whom 13.9% tested positive. Of these, 4.9% had EGFRex20ins. The median time from NSCLC diagnosis to the first positive EGFRex20ins test result was 23 days, including 9 days of laboratory testing time. The EGFRex20ins were reported in 0.6% to 1.0% of all patients with advanced NSCLC and account for 3.9% to 5.3% of all EGFR mutations. During the study period, reverse transcription–polymerase chain reaction testing rates decreased whereas next-generation sequencing rates increased both in overall and among patients with tumors positive for EGFRex20ins. Tissue was the most common sample type used for EGFR and EGFRexon20ins detection (81.1% and 84.9%, respectively), whereas blood sampling for EGFRexon20ins detection increased from 0% (2011) to 37.2% (2020). For 23.7% of patients with EGFRex20ins, treatment was initiated before receiving the first positive EGFRex20ins test result, with therapies including immuno-oncology agents as the most common treatment type from 2017 to 2020. Conclusions: EGFR testing and detection of EGFRex20ins in patients with NSCLC have increased slightly over time with the increasing use of next-generation sequencing. The current late-stage development of EGFRex20ins-targeted therapy is driving a need for more efficient testing.
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