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Boehringer Ingelheim HCP Survey:

Patients with EGFR Mutations Missing Out On Personalized Treatments

Published: Dec 07, 2016

  • International survey showed high global EGFR testing rates prior to first-line lung cancer therapy but highlighted a shortfall in the number of test results received before deciding on therapy
  • Nearly one in five patients are at risk of missing out on treatments personalised to their specific lung cancer type
  • In addition, more than half of all physicians surveyed did not recognize differences between available targeted therapies to treat EGFR mutation-positive lung cancer

Results from a new international survey of physicians revealed more patients with advanced non-small cell lung cancer (NSCLC) could benefit from targeted therapy based on their lung cancer type, over the use of chemotherapy. Test results to identify EGFR mutations were not available prior to deciding on therapy for nearly one in five (18%*) patients for whom a test was ordered. The goal of personalized therapy for all eligible patients remains out of reach for many, despite international guidelines which recommend molecular testing for EGFR mutation and ALK rearrangements in lung cancer patients at diagnosis, to guide treatment decisions. The survey results were presented today as a late-breaking abstract at the 2016 World Conference on Lung Cancer (WCLC) in Vienna, Austria.

“This international survey helps to bring the current advanced lung cancer treatment landscape into the spotlight, and interestingly track what has and hasn’t changed in the last year”

Dr. Vera Hirsh, medical oncologist in the Department of Medical Oncology at Royal Victoria Hospital in Montreal, and Professor at McGill University commented, “This survey highlights both encouraging and concerning results for the treatment of first-line non-small cell lung cancer patients. Whilst globally EGFR testing rates were on average high at 80%*, if physicians do not have access to ordered test results prior to first-line treatment this defeats the purpose of such testing. This survey helps us to observe an incomplete implementation of guidelines, which brings forth a significant area of need. Ensuring patients do not miss out on personalised treatment, which could greatly benefit outcomes, is key.”

The survey of 707 physicians in 11 countries (Canada, China, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, UK, USA), sponsored by Boehringer Ingelheim, aimed to identify year-on-year improvements and changes in EGFR mutation testing rates and treatment practices in NSCLC, when compared to an inaugural survey in 2015.

In comparison to 2015, the number of tests ordered but not received prior to first-line treatment decreased (23% in 2015; 18%* in 2016), however treatment decisions were still made before knowing mutation status for one in five patients. Turnaround time for test results could be a key barrier. For the majority of patients tested for EGFR mutations, results were available within 10 business days. However approximately one test result out of every four globally (24%*) was received later, meaning treatment decisions were possibly delayed or not informed by mutation status.

“This international survey helps to bring the current advanced lung cancer treatment landscape into the spotlight, and interestingly track what has and hasn’t changed in the last year,” said Dr. Matthew Peters, Chair of the Global Lung Cancer Coalition (GLCC). “These patients can benefit from targeted treatments, but crucial steps in the treatment pathway are mutation testing in the first instance, receiving accurate test results in time to guide therapy, and understanding the different treatment benefits of available therapies. The key conclusion is that more is needed to support physicians in their goal to improve outcomes for EGFR mutation-positive patients.”

Further findings from the international survey showed that:

  • Globally nearly four out of five (79%*) EGFR mutation-positive patients were treated first-line with tyrosine kinase inhibitors (TKIs) in 2016, consistent with 2015 (80%), with large country variances.
  • Over half (51%*) of physicians did not differentiate between available EGFR targeted therapies. Recent data has helped physicians make informed treatment decisions between first- and second-generation TKIs.
  • Over half (54%*) of physicians deemed prolonging of survival / extending life as the most important goal in first-line treatment, consistent with the primary goal reported in last year’s survey (63%).
  • When asked what the most important treatment attribute was when choosing a first-line therapy, 54%* of physicians selected a clinically relevant increase in overall survival, followed by an increase in progression-free survival (18%*), strong improvement of health related quality of life (8%*) and meaningful overall response rate (ORR 8%*).

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