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ORIGINAL ARTICLE: LUNG CANCER
Year : 2018  |  Volume : 7  |  Issue : 3  |  Page : 203-206

Patterns of epidermal growth factor receptor testing across 111 tertiary care centers in India: Result of a questionnaire-based survey


1 Department of Medical Oncology, Tata Memorial Hosptial, Mumbai, India
2 Department of Medical Oncology, Asian Institute of Oncology, Mumbai, India
3 Department of Medical Oncology, Indo American Hospital, Hyderabad, Telangana, India
4 Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
5 Department of Medical Oncology, Shatabdi Hospital, Nasik, Maharashtra, India
6 Department of Medical Oncology, HCG Hospital, Bengaluru, Karnataka, India
7 Department of Medical Oncology, Vendant Hospital, Ahmedabad, Gujarat, India
8 Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
9 Department of Oncology/Respiratory Medical Affairs, Boehringer Ingelheim India Pvt. Ltd., Mumbai, India
10 Department of Medical Oncology, Sparsh Hospital, Bhubaneswar, Odisha, India
11 Department of Medical Oncology, Chirayu Hospital, Bhopal, Madhya Pradesh, India
12 Department of Medical Oncology, Tata Medical Centre, Kolkata, West Bengal, India
13 Department of Medical Oncology, Narayana Superspeciality Hospital, Kolkata, West Bengal, India
14 Department of Medical Oncology, Apollo Hospitals, New Delhi, India
15 Department of Medical Oncology, Medanta - The Medicity, Gurugram, Haryana, India
16 Department of Medical Oncology, RGCI, New Delhi, India

Correspondence Address:
Dr. Kumar Prabhash
Department of Medical Oncology, Tata Memorial Hosptial, Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sajc.sajc_30_18

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Background: We conducted a survey of 111 medical oncologists across India to understand the current pattern of epidermal growth factor receptor (EGFR) mutation testing at their respective centers. Methods: Medical oncologists from 111 institutes across India were interviewed face to face using a structured questionnaire. They were divided into two groups – Group 1 with in-house EGFR testing and Group 2 who send samples to central/commercial laboratories outside their institutions. Answers of the two groups were analyzed to see the prevailing patterns of EGFR testing and differences between the two groups if any. Results: Ninety-five percent (105/111) of medical oncologists recommended testing for EGFR mutations in patients with adenocarcinoma histology and 40% (44/111) recommended EGFR testing in squamous cell histology. The average time duration to get EGFR test results was 10 days in Group 1 centers versus 18 days in Group 2 centers. Ninety-six percent (106/111) of the medical oncologists from Group 1 centers requested for factoring additional sample for biomarker testing compared to 69% (77/111) of the oncologists from Group 2 centers. Sixty-nine percent (77/111) of medical oncologists in Group 1 centers would prefer to wait for the test results before initiating treatment compared to 46% (51/111) in Group 2. EGFR tyrosine-kinase inhibitors were used in only approximately 60% of patients with diagnosed EGFR mutation in the first line. For patients in whom chemotherapy was initiated while waiting for test results, 50% (56/111) of medical oncologists would prefer to complete 4–6 cycles before switching to targeted therapy. At the time of progression, rebiopsy was possible in approximately 25% of the patients. Conclusions: Turnaround time for molecular testing should improve so that eligible patients can benefit from targeted therapies in the first line. There is a need to increase the awareness among pulmonologists, oncologists, and interventional radiologists regarding the importance of adequate samples required for molecular tests.


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