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Current Oncology
Volume 24
Issue 1
10.3747/co.24.3266
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists

by
P.K. Cheema
1,*,
S. Raphael
2,
R. El-Maraghi
3,
J. Li
4,
R. McClure
5,
L. Zibdawi
6,
A. Chan
7,
J.C. Victor
8,
A. Dolley
9 and
A. Dziarmaga
9
1
Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
2
Department of Anatomic Pathology, North York General Hospital, Toronto, ON, Canada
3
Department of Medical Oncology/Hematology, Royal Victoria Regional Health Centre, Barrie, ON, Canada
4
Department of Medical Oncology/ Hematology, Michael Garron Hospital, Toronto, ON, Canada
5
Department of Anatomic Pathology, Health Sciences North, Sudbury, ON, Canada
6
Department of Medical Oncology/Hematology, Southlake Regional Health Centre, Newmarket, ON, Canada
7
Department of Medical Oncology/ Hematology, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada
8
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
9
AstraZeneca Canada Inc., Mississauga, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(1), 16-22; https://doi.org/10.3747/co.24.3266
Submission received: 10 November 2016 / Revised: 11 December 2016 / Accepted: 15 January 2017 / Published: 1 February 2017

Abstract

Background: Testing for mutation of the EGFR (epidermal growth factor receptor) gene is a standard of care for patients with advanced nonsquamous non-small-cell lung cancer (nsclc). To improve timely access to EGFR results, a few centres implemented reflex testing, defined as a request for EGFR testing by the pathologist at the time of a nonsquamous nsclc diagnosis. We evaluated the impact of reflex testing on EGFR testing rates. Methods: A retrospective observational review of the Web-based AstraZeneca Canada EGFR Database from 1 April 2010 to 31 March 2014 found centres within Ontario that had requested EGFR testing through the database and that had implemented reflex testing (with at least 2 years’ worth of data, including the pre- and post-implementation period). Results: The 7 included centres had requested EGFR tests for 2214 patients. The proportion of pathologists requesting EGFR tests increased after implementation of reflex testing (53% vs. 4%); conversely, the proportion of medical oncologists requesting tests decreased (46% vs. 95%, p < 0.001). After implementation of reflex testing, the mean number of patients having EGFR testing per centre per month increased significantly [12.6 vs. 4.9 (range: 4.5–14.9), p < 0.001]. Before reflex testing, EGFR testing rates showed a significant monthly increase over time (1.37 more tests per month; 95% confidence interval: 1.19 to 1.55 tests; p < 0.001). That trend could not account for the observed increase with reflex testing, because an immediate increase in EGFR test requests was observed with the introduction of reflex testing (p = 0.003), and the overall trend was sustained throughout the post–reflex testing period (p < 0.001). Conclusions: Reflex EGFR testing for patients with nonsquamous nsclc was successfully implemented at multiple centres and was associated with an increase in EGFR testing.
Keywords: reflex testing; EGFR; biomarkers; non-small-cell lung cancer reflex testing; EGFR; biomarkers; non-small-cell lung cancer

Share and Cite

MDPI and ACS Style

Cheema, P.K.; Raphael, S.; El-Maraghi, R.; Li, J.; McClure, R.; Zibdawi, L.; Chan, A.; Victor, J.C.; Dolley, A.; Dziarmaga, A. Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists. Curr. Oncol. 2017, 24, 16-22. https://doi.org/10.3747/co.24.3266

AMA Style

Cheema PK, Raphael S, El-Maraghi R, Li J, McClure R, Zibdawi L, Chan A, Victor JC, Dolley A, Dziarmaga A. Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists. Current Oncology. 2017; 24(1):16-22. https://doi.org/10.3747/co.24.3266

Chicago/Turabian Style

Cheema, P.K., S. Raphael, R. El-Maraghi, J. Li, R. McClure, L. Zibdawi, A. Chan, J.C. Victor, A. Dolley, and A. Dziarmaga. 2017. "Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists" Current Oncology 24, no. 1: 16-22. https://doi.org/10.3747/co.24.3266

APA Style

Cheema, P. K., Raphael, S., El-Maraghi, R., Li, J., McClure, R., Zibdawi, L., Chan, A., Victor, J. C., Dolley, A., & Dziarmaga, A. (2017). Rate of Egfr Mutation Testing for Patients with Nonsquamous Non-Small-Cell Lung Cancer with Implementation of Reflex Testing by Pathologists. Current Oncology, 24(1), 16-22. https://doi.org/10.3747/co.24.3266

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