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Ultrarapid EGFR Testing in Non-Small Cell Lung Carcinoma Patients: Findings From a Canadian Clinical Testing Workflow
Kate Fitzsimmons1, Curtis Hughesman2, Reka Pataky3
1Undergraduate Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Laboratory Investigation; a Journal of Technical Methods and Pathology
|September 26, 2025
Summary
Ultrarapid single-gene testing for EGFR mutations in lung cancer offers a fast turnaround time and comparable costs to panel sequencing. This approach is beneficial for patients with urgent needs or high mutation probability, enabling quicker treatment decisions.
Area of Science:
- Oncology
- Molecular Diagnostics
- Genetics
Background:
- Lung cancer molecular testing involves single-gene or multigene approaches, each with unique benefits and risks.
- Ultrarapid testing for Epidermal Growth Factor Receptor (EGFR) mutations is clinically relevant for guiding lung cancer treatment.
Purpose of the Study:
- To identify clinical features associated with rapid EGFR testing in lung cancer.
- To evaluate the performance and cost-effectiveness of single-gene versus multigene panel testing in ultrarapid tested patients.
- To assess the clinical outcomes and laboratory costs associated with different molecular testing strategies.
Main Methods:
- Retrospective analysis of lung cancer patients undergoing ultrarapid Idylla EGFR testing.
- Collection of demographic data and laboratory cost information.
- Comparison of ultrarapid EGFR testing with panel sequencing for sensitivity and turnaround time.
Main Results:
- Ultrarapid EGFR testing achieved a median 1-day turnaround time with 95% sensitivity compared to panel sequencing.
- East/Southeast Asian ethnicity and female sex were significantly associated with EGFR mutation positivity.
- The mean cost per patient was comparable between ultrarapid testing ($550.53) and panel sequencing ($571).
Conclusions:
- Single-gene ultrarapid EGFR testing provides a rapid and cost-effective option for lung cancer patients with urgent clinical needs.
- This strategy facilitates timely treatment initiation for patients with a high likelihood of EGFR mutations.
- Molecular testing choices should consider clinical urgency, mutation probability, cost, and diagnostic performance.
