Contribution of the Idylla System to Improving the Therapeutic Care of Patients with NSCLC through Early Screening of Mutations.

Epidermal growth factor receptor (EGFR) genotyping, a critical examen for the treatment decisions of patients with non-small cell lung cancer (NSCLC), is commonly assayed by next-generation sequencing (NGS), but this global approach takes time. To determine whether rapid genotyping tests by the Idylla system guides earlier therapy decisions, mutations were assayed by both the Idylla system and NGS in 223 patients with NSCLC in a bicentric prospective study. Idylla demonstrated agreement with the NGS method in 187/194 cases (96.4%) and recovered 20 of the 26 (77%) mutations detected using NGS. Regarding the seven missed mutations, five were not detected by the Idylla system, one was assayed in a sample with insufficient tumoral cells, and the last was in a sample not validated by the Idylla system (a bone metastasis). Idylla did not detect any false positives. The average time between genotyping results from Idylla and the NGS method was 9.2 ± 2.2 working days (wd) (12.6 ± 4.0 calendar days (cd)). Subsequently, based on the Idylla method, the timeframe from tumor sampling to the initiation of EGFR-TKI was 7.7 ± 1.2 wd (11.4 ± 3.1 cd), while it was 20.3 ± 6.7 wd (27.2 ± 8.3 cd) with the NGS method ( < 0.001). We thus demonstrated here that the Idylla system contributes to improving the therapeutic care of patients with NSCLC by the early screening of mutations.