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EGFR Mutation Testing: Changing Patterns of Molecular Testing in Brazil.

Sofia Palacio1, Luciola Pontes2, Edna Prado3

  • 1Department of Medicine, Miller School of Medicine and Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida, USA sofia.palacio@jhsmiami.org.

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In Brazil, only 38% of non-small cell lung cancer patients undergo EGFR mutation testing, with significant disparities between public and private healthcare sectors. Improving access to this crucial test is vital for better lung cancer survival rates.

Keywords:
BrazilEGFR mutationsGlobal healthLung adenocarcinoma

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Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Public Health

Background:

  • Cancer is a leading cause of death in Brazil, with many patients diagnosed at advanced stages.
  • Current guidelines recommend Epidermal Growth Factor Receptor (EGFR) mutation testing for metastatic adenocarcinoma.
  • Data on EGFR testing frequency and trends in Brazil are limited.

Purpose of the Study:

  • To analyze the frequency and trends of EGFR mutation testing in non-small cell lung cancer (NSCLC) patients in Brazil.
  • To identify disparities in testing rates between public and private healthcare settings.
  • To determine the prevalence of EGFR mutations in Brazilian NSCLC patients.

Main Methods:

  • Retrospective observational study using deidentified data from a commercial database (2011-2016).
  • Analysis of 11,684 NSCLC patients and direct testing of 3,664 tumor samples for EGFR mutations.
  • Data included patients from both public and private healthcare sectors.

Main Results:

  • Overall, 38% of patients were tested for EGFR mutations, with higher rates in the private sector (76%) vs. public (24%).
  • Testing frequency significantly increased from 13% in 2011 to 53% in 2015, then decreased to 42% in 2016.
  • EGFR mutations were detected in 25.5% of tested samples, with Exon 19 deletions being the most common (54%).

Conclusions:

  • The frequency of EGFR mutations in Brazil is higher than in North American/Western European populations but lower than in Asia.
  • Less than half of Brazilian NSCLC patients are tested for EGFR mutations, with a notable disparity in the public sector.
  • Improved awareness and access to EGFR testing are crucial for enhancing lung cancer survival rates in Brazil.