Department of Cancer Genetics, Institute of Cancer Research, Oslo University Hospital, Oslo, Norway; Department of Oncology, Oslo University Hospital, Norway.
Medical, Biopharmaceuticals, AstraZeneca Nordic, Copenhagen, Denmark.
Cancer Treat Res Commun. 2022;33:100636. doi: 10.1016/j.ctarc.2022.100636. Epub 2022 Sep 16.
Testing for epidermal growth factor receptor mutation (EGFRm) status is a prerequisite to identify eligible patients for tyrosine kinase inhibitors (TKI) treatment. However, EGFR testing of patients with non-small cell lung cancer (NSCLC) is suboptimal in many parts of the world. The aim of this study was to describe real-world EGFR testing practice, EGFRm prevalence, and subsequent TKI treatment patterns in Norway.
This retrospective, observational, cohort study included all incident locally advanced and metastatic non-squamous NSCLC patients registered in the Norwegian Cancer Registry during 2010-2017. A cohort with follow-up through 2018 was formed with linkage to nationwide registries on comorbidities, prescribed drugs and causes-of-death.
A total of 10,717 patients were included, of which 35% (3782) with locally advanced NSCLC and 65% (6935) with metastatic disease. Mean age at diagnosis was 71 years and 47% were female. EGFR testing among patients with metastatic NSCLC increased from 41% to >64% between 2010 and 2017, with a relative stable incidence of EGFRm+ (∼9%). More than 85% of EGFRm+ patients received TKI treatment. Patients with the most dismal prognosis (>80 age, comorbidities) and with diagnosis based on cytology/imaging were less likely to be tested. Differences in testing were observed between regions.
Despite increased test rates over the study period, in Norway, a significant proportion of patients with non-squamous metastatic NSCLC are still not tested for EGFR. To maximize the identification of eligible patients for targeted therapies, increased testing is recommended, regardless of age, comorbidity rate and place of residence.
表皮生长因子受体突变（EGFRm）状态检测是确定适合接受酪氨酸激酶抑制剂（TKI）治疗的患者的前提。然而，在世界上许多地区，非小细胞肺癌（NSCLC）患者的 EGFR 检测并不理想。本研究旨在描述挪威的真实世界 EGFR 检测实践、EGFRm 流行率以及随后的 TKI 治疗模式。
这是一项回顾性、观察性队列研究，纳入了 2010-2017 年期间在挪威癌症登记处登记的所有局部晚期和转移性非鳞状 NSCLC 患者。通过与全国范围内的合并症、处方药物和死因登记处进行链接，形成了一个随访至 2018 年的队列。
共纳入 10717 例患者，其中 35%（3782 例）为局部晚期 NSCLC，65%（6935 例）为转移性疾病。诊断时的平均年龄为 71 岁，47%为女性。2010 年至 2017 年间，转移性 NSCLC 患者的 EGFR 检测率从 41%增加到>64%，EGFRm+的相对稳定发病率（~9%）。超过 85%的 EGFRm+患者接受了 TKI 治疗。预后最差的患者（>80 岁，合并症）和基于细胞学/影像学诊断的患者检测率较低。各地区之间存在检测差异。
尽管在研究期间检测率有所增加，但在挪威，仍有相当一部分非鳞状转移性 NSCLC 患者未进行 EGFR 检测。为了最大限度地发现适合接受靶向治疗的患者，建议无论年龄、合并症发生率和居住地如何，都要增加检测。
