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Compliance to regional recommendations for molecular analyses and management of advanced lung cancer patients

Aurélie Swalduz1,2, Pierre-Jean Souquet3, Maurice Pérol2

  • 1Department of Chest Diseases & Thoracic Oncology, University Hospital of Saint-Étienne, 42270, Saint Priest en Jarez, France.

Future Oncology (London, England)
|June 13, 2019
PubMed

Insights

Adherence to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) guidelines for non-small cell lung cancer was 76.4%. Multidisciplinary meetings improved guideline compliance and subsequent treatment timelines.

Area of Science:

  • Oncology
  • Clinical Audit
  • Molecular Diagnostics

Background:

  • Introduction of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) as first-line treatment for EGFR-mutated non-small cell lung cancer (NSCLC).
  • Need to assess clinical practice patterns and guideline adherence post-implementation.

Purpose of the Study:

  • To conduct a clinical audit evaluating the management of NSCLC patients with EGFR mutations one year after the introduction of first-line EGFR-TKIs.
  • To assess compliance with French national guidelines for tumor molecular profiling and first-line treatment selection.

Main Methods:

  • Retrospective clinical audit of 169 patients with EGFR-mutated NSCLC (Stage IIIB/IV).
  • Compliance defined by adherence to molecular profiling and recommended first-line EGFR-TKI treatment.
  • Analysis of factors associated with noncompliance, including multidisciplinary meetings and institutional type.

Main Results:

  • Overall compliance with guidelines was 76.4%.
  • Chemotherapy use instead of EGFR-TKI was the most frequent noncompliance.
  • Lack of multidisciplinary meetings and institutional factors were linked to lower compliance.
  • Guideline compliance significantly correlated with improved time to first subsequent treatment (2.5 vs. 9.1 months, p < 0.0001).

Conclusions:

  • Implementing new standards of care, such as first-line EGFR-TKIs, presents challenges in clinical practice.
  • Multidisciplinary meetings are crucial for improving adherence to treatment guidelines.
  • Enhanced multidisciplinary collaboration can facilitate better patient access to innovative therapeutics.
Keywords:
mutationsclinical auditmultidisciplinary meetingsnon-small-cell lung cancertyrosine kinase inhibitors

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