Table 4.
Testing Frequency for EGFR Mutations and/or ALK Rearrangements in Patients with Advanced NSCLC
| Testing Frequency | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Author | Period | Location | Method | No. Centers/HCPs | n | Overall, n (%) | EGFR, n (%) | ALK, n (%) | Dx Tests |
| North America | |||||||||
| Pan125 | 2007–2011 | USA | RR | iKnowMedTMdatabasea | 1168 | 128 (11%) 2% <2010; 32% in 2011 | 28 (2%) | ||
| Enewold117 | 2010 | USA | RR | SEER Databaseb | 1358 | 228 (17%) 157 (21%) in AdC | |||
| MacLean123 | 2010–2012 | USA | RR | Humana Research Database | 2623 | 1579 (61%) | |||
| Lim122 | 2010–2013 | CAN | RR | 1 center | 258c | 150 (58%) | 50 (19%) | IHC/FISH/NGS | |
| Shen126 | 2013–2014 | USA | RR | Marketscan Databased | 5842 | 1039 (18%) | 1039 (18%) | ||
| Gutierrez118 | 2013–2015 | USA | RR | 15 centers/89 oncol. | 814 | 479 (59%) | PCR/FISH/NGS | ||
| Schink135 | 2014 | USA | S | 57 centers | NA | 57 (100%) | 57 (100%) | 57 (100%) | EGFR – PCR 44%; ALK – FISH 64% |
| Illei119 | 2011–2017 | USA | RR | Flatiron Health Database | 31,483 | 16,726 (53%) 32% 2011; 62% 2016 | |||
| South America | |||||||||
| Palacio124 | 2011–2016 | BRA | RR | All public and private settings | 11,684 | 4440 (38%) 13% 2011; 42% 2016 | SS | ||
| Europe | |||||||||
| Sluga127 | 2008–2014 | NL | RR | 4 centers | 2206 | 879 (40%)e 11% 2008; 75% 2014 | |||
| Ess42 | 2008–2014 | SUI | RR | 1 center | 718 | 447 (62%) | 265 (37%) | ||
| Don-Carolis130 | 2014 | UK | S | 15 centers | 23,131f | 12,140 (53%) | 12,140 (53%) includes both ALK and EGFR testing | ||
| Gobbini138 | 2014–2015 | ITL | OS | 38 centers | 1787 | 1388 (78%) | 1353 (76%) | 942 (53%) | EGFR-direct sequencing; ALK-IHC and/or break apart FISH; NGS in some centers |
| Ryska136 | 2014–2015 | Central, Eastern Europeg | S | 42 oncol. | NA | 75–100% | ALK testing – all except BG | EGFR: RT-PCR; ALK-IHC + FISH and/or FISH alone. ISR, NGS | |
| Middle East | |||||||||
| Bar137 | 2013 | ISR | S | 24 oncol. | 19 (79.2%) | ||||
| Asia-Pacific | |||||||||
| McKeage139 | 2010–2016 | NZ | OS | All non-SCC NSCLC from Auckland, Manukau, Waitemata and Northland | 3130 | 407 (13%) | Vysis break apart FISH | ||
| Yatabe128 | 2011–2012 | Asia-Pac | RR | 40 centers/11 countriesh | 22,193 | 18% (CHN) – 65% (JPN)i | DNA sequencing. 75% – IHC (poorly differentiated samples) | ||
| Hotta131 | 2012 | JPN | S | 871 oncol. | NA | 775 (89%) | 525 (60%) | ||
| Isobe120 | 2011–2013 | JPN | RR | 5 centers | 129c | 105 (81%) | 105 (81%) | 25 (19%) | |
| Zhou129 | 2015–2016 | CHN | RR | 12 centers | 932 | 665 (71%) | 416 (45%) | ||
| Prabhash134 | 2015–2016 | IND | INTV | 111 oncol. | NA | 105 (95%) | 105 (95%) | ||
| International | |||||||||
| Lee121 | 2011–2013 | INT | RR | 78 centers/8 countriesj | 1440 | 43% (BRA) – 85% (TW) | 41% (DE) – 97% (TW)j | 3% (TW) – 27% (ITL) | |
| Peters133 | 2014–2016 2016–2016 | INT | 2 surveysk | S1: 562 oncol.l S2: 707 oncol.m |
NA | 450 (80%) | |||
| Jankovic132 | 2017–2018 | INT | S | 36 oncol./18 countriesn | NA | 90% guided by test results | 85% | 58% | PCR 60%; SS 26%; NGS 26%; FISH 26%; IHC 16% |
Notes:aCaptures demographic, clinical, laboratory and treatment data for patients receiving care within US Oncology’s network of approximately 1200 community-based oncologists. bRandom selection of patients with NSCLC in the SEER Database. cData are reported for patients with non-SCC only. dMarketscan Database contains health insurance claims for 50 million individuals from >100 large- or medium-sized US-based employers. e853 patients had NSCLC-NOS or AdC, 26 had SCC. fPatients eligible for an EGFR diagnostic test. gBulgaria, Croatia, Czech Republic, Israel, Slovakia, Slovenia, Poland, Hungary, Turkey. hChina, Hong Kong, Indonesia, Japan, South Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand and Vietnam. iData not provided by Indonesia, Malaysia, Singapore, the Philippines or Vietnam. jItaly (69%), Spain (56%), Germany (41%), Australia (64%), Japan (81%), South Korea (44%), Taiwan (97%) and Brazil (81%). kTwo surveys, 18 months apart. lCanada, France, Germany, Italy, Japan, South Korea, Spain, Taiwan, UK and USA. mSurvey 2 included physicians from China. nPortugal, Serbia, Morocco, UK, Azerbaijan, Uzbekistan, Peru, Brazil, Kuwait, France, Spain, Austria, Estonia, Belgium, Montenegro, Nigeria, USA and Poland.
Abbreviations: AdC, adenocarcinoma; ALK, anaplastic lymphoma kinase; BRA, Brazil; CAN, Canada; CHN, China; DE, Germany; Dx, diagnostic; EGFR, epidermal growth factor receptor; FISH, fluorescence in situ hybridization; HCP, healthcare professional; IHC, immunohistochemistry; IND, India; INT, international; INTV, interview; ITL, Italy; ISR, Israel; JPN, Japan; NA, not available; NGS, next-generation sequencing; NL, Netherlands; NOS, not otherwise specified; NR, not reported; NSCLC, non-small-cell lung cancer; NZ, New Zealand; oncol, oncologist; OS, observational study; Ref, reference; RR, retrospective review; RT PCR, reverse transcriptase polymerase chain reaction; S, survey; SCC, squamous cell carcinoma; SD, standard deviation; SEER, Surveillance Epidemiology and End Results; SS, Sanger sequencing; SUI, Switzerland; TAT, turnaround time; TW, Taiwan; UK, United Kingdom; USA, United States of America.