Related Experiment Video
Updated: Jul 23, 2025
Profiling Sensitivity to Targeted Therapies in EGFR-Mutant NSCLC Patient-Derived Organoids
Published on: November 22, 2021
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.
Purpose:
Targeted therapy yields superior outcomes relative to genotype-agnostic therapy for patients with epidermal growth factor receptor (EGFR)-mutant lung cancer. Workflows that facilitate timely detection of EGFR mutations and early dispensation of osimertinib can improve management of this disease.
Methods:
We developed an Integrated Radiology, Pathology, and Pharmacy Program to minimize delays in initiating osimertinib. The intervention consisted of parallel workflows coupling interventional radiology, surgical pathology, and analysis of nucleic acids from frozen tissue with early pharmacy engagement. We compared time to EGFR testing results and time to treatment for participating patients with those of historical cohorts.
Results:
Between January 2020 and December 2021, 222 patients participated in the intervention. The median turnaround time from biopsy to EGFR results was 1 workday. Forty-nine (22%) tumors harbored EGFR exon 19 deletions or EGFR L858R. Thirty-one (63%) patients were prescribed osimertinib via the intervention. The median interval between osimertinib prescription and osimertinib dispensation was 3 days; dispensation occurred within 48 hours for 42% of patients. The median interval between biopsy and osimertinib dispensation was 5 days. Three patients received osimertinib within 24 hours of EGFR results. Compared with patients with EGFR-mutant non-small-cell lung cancer who were diagnosed through routine workflows, the intervention led to a significant reduction in median time between biopsy and EGFR results (1 v 7 days; P < .01) and median time to treatment initiation (5 v 23 days; P < .01).
Conclusion:
Combining radiology and pathology workflows with early parallel pharmacy engagement leads to a significant reduction in time to initiating osimertinib. Multidisciplinary integration programs are essential to maximize clinical utility of rapid testing.
Insights
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.
