Routine implementation of EGFR mutation testing in clinical practice in Flanders: 'HERMES' project.

Area of Science:

• Oncology
• Molecular Diagnostics
• Genetics

Background:

• Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are first-line treatments for metastatic EGFR-mutation-positive non-small cell lung cancer (NSCLC).
• Personalized treatment necessitates rapid EGFR mutation testing for NSCLC patients.
• The frequency of EGFR mutations in the Flemish population and the turnaround time (TAT) for testing were previously undetermined.

Purpose of the Study:

• To determine the turnaround time (TAT) for EGFR mutation testing in NSCLC patients within the Antwerp region.
• To ascertain the frequency of EGFR mutations in this specific Flemish patient cohort.
• To evaluate the feasibility of implementing timely EGFR mutation testing in clinical practice.

Main Methods:

• Tumor tissue samples were prospectively collected from 107 lung cancer patients.
• Samples were analyzed for EGFR mutations in two central laboratories.
• Turnaround time (TAT) was defined as the interval from oncologist request to result delivery.

Main Results:

• The median TAT for EGFR mutation test results was 10 days from the local lab and 9 days from central labs.
• EGFR mutations were detected in 7% (7 out of 107) of the study population.
• All detected mutations (six exon 19 deletions, one L858R) occurred in adenocarcinoma histology, predominantly in (ex-)smokers and males.

Conclusions:

• Timely reporting of EGFR mutation status is achievable in clinical settings.
• EGFR mutations are present in 7% of Flemish NSCLC patients.
• Testing for EGFR mutations is recommended for all advanced non-squamous NSCLC patients, irrespective of gender or smoking history.