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Anne Van Lindert



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      3P - Notable variation of molecular testing in metastatic lung cancer in the Netherlands (ID 229)

      12:30 - 13:00  |  Author(s): Anne Van Lindert

      • Abstract
      • Slides

      Background

      Adequate and timely testing for molecular alterations in NSCLC is necessary to enable treatment with tyrosine kinase inhibitors (TKI) when a certain mutation or rearrangement is present. On a nationwide basis, we aimed to assess the performance of molecular testing for EGFR and/or KRAS mutation, and ALK and ROS rearrangement in a cohort of metastatic NSCLC.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      All stage IV non-squamous NSCLC from 2013 and 2015 were identified from the Netherlands Cancer Registry and matched to the Dutch Pathology Registry (PALGA). Using information extracted from pathology reports, proportions of tumors tested for EGFR and/or KRAS and ALK, and in 2015 also for ROS, within 3 months after diagnosis, were determined, and variation between 48 laboratories was assessed. In a best practice session with 4 laboratories with highest testing proportions, we tried to identify a process for the best possible flow and highest possible testing proportions.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      In total, 6,619 tumors were included (2013: N = 3,195; 2015: N = 3,424). In 2013, EGFR and/or KRAS testing was performed in 73.1% (variation between laboratories 30.6% to 91.7%) and was significantly higher in 2015: 78.9% (40.0% to 91.0%). Of the EGFR/KRAS wildtype (wt) tumors, 49.5% underwent ALK testing in 2013 (6.3% to 100%) and 77.4% in 2015 (32.5% to 100%), which was significantly higher. ROS testing was performed for 50.9% (0% to 100%) of the EGFR/KRAS wt tumors from 2015. In 2015, 6, 7 and 13 laboratories tested significantly less often for EGFR/KRAS, ALK and ROS, respectively, than the national proportion. Insufficient tissue was the most stated reason for not testing. The best practice session showed that, among other, dedicated specialized personnel, good communication with short lines, and a work culture of critical openness and honesty are essential for adequate molecular testing.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Although molecular testing proportions were significantly higher in 2015, improvement remains possible in some laboratories/hospitals, considering that some patients were possibly unjustly not eligible for TKI. Feedback on molecular testing performance was sent to individual laboratories, so they can review, and, if needed, improve their practice.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      University Medical Centre Utrecht.

      213f68309caaa4ccc14d5f99789640ad Funding

      AstraZeneca, Pfizer, Roche.

      682889d0a1d3b50267a69346a750433d Disclosure

      C. Kuijpers, S. Willems: Funding: AstraZeneca, Pfizer, Roche (these companies had no role in study design, analyses and reporting). All other authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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