PMID- 33652831
OWN - NLM
STAT- MEDLINE
DCOM- 20210924
LR  - 20210924
IS  - 1718-7729 (Electronic)
IS  - 1198-0052 (Print)
IS  - 1198-0052 (Linking)
VI  - 28
IP  - 2
DP  - 2021 Feb 26
TI  - Improvement of EGFR Testing over the Last Decade and Impact of Delaying TKI 
      Initiation.
PG  - 1045-1055
LID - 10.3390/curroncol28020102 [doi]
AB  - BACKGROUND: Epidermal growth factor receptor (EGFR) is the most common oncogenic 
      mutation in lung adenocarcinoma and tyrosine kinase inhibitors (TKIs) have been 
      considered standard treatment for more than a decade. However, time to initiation 
      of TKIs (TTIT) from diagnosis is often delayed and represents a challenge for 
      clinicians. We aimed to assess the impact of TTIT on clinical outcomes and 
      complications. METHOD: TTIT was defined as the time between confirmed advanced 
      diagnosis and the initiation of a TKI. Complications during this pre-TKI period 
      were retrospectively collected from all patients with EGFR-mutant non small cell 
      lung cancer (NSCLC) in our institution. RESULTS: 102 patients were diagnosed with 
      EGFR mutated NSCLC between 2006 and 2019. The median PFS and OS were 12.9 and 
      22.5 months, respectively. TTIT was 5.7 months (95% CI 3.4-8) with a significant 
      decrease in the latter years of this cohort. During the pre-TKI period, 23 
      patients received chemotherapy as first line treatment, of which 5 developed 
      severe adverse events and 3 were not fit to receive TKI thereafter. Additionally, 
      29 patients had rapid clinical deterioration before initiation of first line TKI 
      and 16 had to be hospitalized. Among the patients presenting a performance status 
      deterioration, their prognosis was markedly affected compared to the remainder of 
      the cohort (p = 0.01). CONCLUSION: Our real-world evidence study supports the 
      concept that a delay to treat EGFR mutant NSCLC with TKIs is associated with 
      adverse events, patient progression, hospitalization, and decreased overall 
      survival. Rapid molecular diagnosis, including access to ctDNA technology may 
      circumvent these deleterious delays.
FAU - Blanc-Durand, Felix
AU  - Blanc-Durand F
AUID- ORCID: 0000-0002-5277-1515
AD  - Hematology and Medical Oncology Service, Centre Hospitalier Universitaire de 
      Montreal, University of Montreal, Montreal, QC H2X 3E4, Canada.
FAU - Florescu, Marie
AU  - Florescu M
AD  - Hematology and Medical Oncology Service, Centre Hospitalier Universitaire de 
      Montreal, University of Montreal, Montreal, QC H2X 3E4, Canada.
FAU - Tehfe, Mustapha
AU  - Tehfe M
AD  - Hematology and Medical Oncology Service, Centre Hospitalier Universitaire de 
      Montreal, University of Montreal, Montreal, QC H2X 3E4, Canada.
FAU - Routy, Bertrand
AU  - Routy B
AD  - Hematology and Medical Oncology Service, Centre Hospitalier Universitaire de 
      Montreal, University of Montreal, Montreal, QC H2X 3E4, Canada.
FAU - Alameddine, Raafat
AU  - Alameddine R
AD  - Hematology and Medical Oncology Service, Centre Hospitalier Universitaire de 
      Montreal, University of Montreal, Montreal, QC H2X 3E4, Canada.
FAU - Tran-Thanh, Danh
AU  - Tran-Thanh D
AD  - Pathology Department, Centre Hospitalier Universitaire de Montreal, University of 
      Montreal, Montreal, QC H2X 3E4, Canada.
FAU - Blais, Normand
AU  - Blais N
AUID- ORCID: 0000-0003-2698-4362
AD  - Hematology and Medical Oncology Service, Centre Hospitalier Universitaire de 
      Montreal, University of Montreal, Montreal, QC H2X 3E4, Canada.
AD  - Hematology/Oncology Department, CHUM, 1000, Rue Saint-Denis, Montreal, QC H2X 
      0C1, Canada.
LA  - eng
PT  - Journal Article
DEP - 20210226
PL  - Switzerland
TA  - Curr Oncol
JT  - Current oncology (Toronto, Ont.)
JID - 9502503
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (EGFR protein, human)
RN  - EC 2.7.10.1 (ErbB Receptors)
SB  - IM
MH  - *Carcinoma, Non-Small-Cell Lung/diagnosis/drug therapy/genetics
MH  - ErbB Receptors/genetics
MH  - Humans
MH  - *Lung Neoplasms/diagnosis/drug therapy/genetics
MH  - Mutation
MH  - Protein Kinase Inhibitors/adverse effects
MH  - Retrospective Studies
PMC - PMC8025752
OTO - NOTNLM
OT  - EGFR
OT  - liquid biopsy and precision medicine
OT  - lung cancer
OT  - real-world evidence
COIS- The authors declare no conflict of interest.
EDAT- 2021/03/04 06:00
MHDA- 2021/09/25 06:00
PMCR- 2021/02/26
CRDT- 2021/03/03 01:01
PHST- 2020/06/26 00:00 [received]
PHST- 2020/06/26 00:00 [revised]
PHST- 2020/11/06 00:00 [accepted]
PHST- 2021/03/03 01:01 [entrez]
PHST- 2021/03/04 06:00 [pubmed]
PHST- 2021/09/25 06:00 [medline]
PHST- 2021/02/26 00:00 [pmc-release]
AID - curroncol28020102 [pii]
AID - curroncol-28-00102 [pii]
AID - 10.3390/curroncol28020102 [doi]
PST - epublish
SO  - Curr Oncol. 2021 Feb 26;28(2):1045-1055. doi: 10.3390/curroncol28020102.