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Integrated Radiology, Pathology, and Pharmacy Program to Accelerate Access to Osimertinib
Ibiayi Dagogo-Jack1,2, Amanda Manoogian3, Nicholas Jessop4
1Massachusetts General Hospital Cancer Center, Boston, MA.
JCO Oncology Practice
|July 12, 2023
Summary
An integrated program significantly reduced time to EGFR mutation results and osimertinib treatment for lung cancer patients. This multidisciplinary approach streamlines diagnosis and therapy initiation, improving patient outcomes.
Area of Science:
- Oncology
- Medical Diagnostics
- Pharmacology
Background:
- Targeted therapy, specifically osimertinib, offers superior outcomes for patients with epidermal growth factor receptor (EGFR)-mutant lung cancer compared to genotype-agnostic approaches.
- Timely detection of EGFR mutations is crucial for initiating effective treatment and improving patient management.
Purpose of the Study:
- To develop and evaluate an Integrated Radiology, Pathology, and Pharmacy Program designed to minimize delays in initiating osimertinib treatment for EGFR-mutant lung cancer.
- To assess the impact of this integrated program on the time to EGFR testing results and the time to treatment initiation.
Main Methods:
- The intervention involved parallel workflows integrating interventional radiology, surgical pathology, and nucleic acid analysis from frozen tissue.
- Early pharmacy engagement was incorporated into the parallel workflows.
- Time metrics (biopsy to EGFR results, biopsy to osimertinib dispensation) were compared between patients in the intervention group and historical control cohorts.
Main Results:
- The integrated program achieved a median turnaround time of 1 workday from biopsy to EGFR results.
- The median interval from biopsy to osimertinib dispensation was 5 days, a significant reduction compared to routine workflows (23 days).
- The intervention led to a significant reduction in median time between biopsy and EGFR results (1 vs. 7 days) and median time to treatment initiation (5 vs. 23 days; P < .01).
Conclusions:
- Integrating radiology and pathology workflows with early, parallel pharmacy engagement significantly reduces the time to initiate osimertinib treatment.
- Multidisciplinary integration programs are essential for maximizing the clinical utility of rapid diagnostic testing in oncology.
- This streamlined approach enhances the management of EGFR-mutant lung cancer by accelerating treatment initiation.
