Insights from experts working on-the-ground in lung cancer, compiled by Boehringer Ingelheim, shed light on challenges faced by patients with advanced stage adenocarcinoma, a type of non-small cell lung cancer (NSCLC), in being tested for EGFR mutations, leaving some without access to the most appropriate treatment for them.
A new insights report sees healthcare professionals and patient group representatives reflect on existing gaps in nationwide EGFR testing, which should be conducted for eligible patients upon diagnosis according to guidelines.
Dr Matthew Peters, Professor of Respiratory Medicine, Macquarie University Australia and Chair, Global Lung Cancer Coalition commented, “Whilst country-level insights within this report do vary, common barriers to achieving EGFR testing and personalised treatment for all eligible patients are clear. Education is key: for patients, healthcare professionals and the wider community. More is needed to bring us closer to helping each and every NSCLC patient receive the right treatment for them.”
Country-level themes identified by experts from Western Europe and North America include:
- Germany: insufficient reimbursement for mutation tests impacts EGFR testing rates for inpatients (majority of patients are diagnosed in an inpatient setting)
- Italy: high number of patients are tested for EGFR mutations, but some patients and caregivers ask to start first-line treatment before receiving test results
- Spain: many cancer centres are currently achieving high EGFR testing rates, but disparity exists as some centres are increasingly impacted by the growing economic crisis
- UK: despite high levels of EGFR testing, some patients start treatment before results of this testing are available, so treatment is not personalised for their mutation
- Canada: a healthcare system which is publically funded through each province and territory brings forth challenges in ensuring all eligible patients across the country are EGFR tested at diagnosis
- USA: a substantial percentage of treatment decisions are not based on EGFR mutation subtype resulting in patients not receiving the most appropriate personalised treatment plans
Experts unite with a shared vision where all eligible NSCLC patients have the most appropriate diagnostic tests and access to personalised treatment. Common barriers holding back the realisation of this vision include difficulties in obtaining adequate tumour tissue samples to test, and delays in receiving test results. This is important as data have shown that EGFR targeted treatments significantly delay disease progression when compared to chemotherapy. For a specific targeted therapy, extended overall survival of patients with the most common type of mutation (del19) when compared to chemotherapy has also been observed.
Dr Mehdi Shahidi, Medical Head, Solid Tumour Oncology, Boehringer Ingelheim added, “EGFR testing rates have improved dramatically over recent years, but there is still work to be done. Targeted therapies can benefit patients with EGFR mutation-positive lung cancer by delaying disease progression and for some, offering survival advantages compared to chemotherapy. This is why EGFR mutation testing and acting on the results of these tests is so important. Healthcare teams need to optimise the tools, resources and tests available to improve access to personalised treatment, for the ultimate benefit of patients.”
