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Abstract
Aims Somatic genetic testing in non-squamous, non-small cell lung carcinoma (NSCLC) patients is required to highlight subgroups eligible for a number of novel oncological therapies. This study aims to determine whether turnaround times for reporting epidermal growth factor receptors (EGFR) by next-generation sequencing (NGS) alone is sufficient to meet the needs of lung cancer patients.
Methods We performed a retrospective case series with follow-up. Outcomes of EGFR testing (102 tests) in 96 patients by NGS were compared with a rapid, fully automated PCR-based platform (Idylla) in local histopathology laboratories.
Results Turnaround time for reporting NGS was 17 calendar days. Reporting using the Idylla EGFR Mutation Test, by contrast, gave a potential turnaround time of 3.8 days from request to authorisation. Three-quarters of patients presenting with stage IV disease had a performance status of 0, 1, or 2 but 18% experienced rapid clinical deterioration (p<0.05). A third of these patients were deceased by the time NGS reports were available.
Conclusions We discuss issues around integrating rapid PCR testing alongside NGS in multidisciplinary care pathways and strategies for mitigating against foreseeable difficulties. Dual testing for stage IV non-squamous, NSCLC patients has the potential to improve care and survival outcomes by providing access to the right test at the right time.
- genes
- neoplasm
- lung neoplasms
- medical oncology
- pathology
- surgical
- polymerase chain reaction
Data availability statement
Data are available on reasonable request. Please contact first author by email with reasonable data requests.
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Data availability statement
Data are available on reasonable request. Please contact first author by email with reasonable data requests.
Footnotes
Handling editor Runjan Chetty.
Contributors AF wrote the manuscript, scored slides for tumour nuclear content (TNC), performed data analysis and interpretation and constructed a standard operating procedure in collaboration with stakeholders. GD performed Idylla EGFR Mutation testing and collated all data. TJ scored slides for TNC for NGS send away testing. GE, AM and PH contributed to a working concept of integration with NGS data. All authors reviewed, amended and agreed manuscript content. AF is responsible for the overall content as the guarantor.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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