ISPOR: New data highlights need for increased EGFR testing in NSCLC; spots alarming gaps for Asian American patients

May 08, 2023

by Patrick Curry, Vice President and General Manager, Life Sciences at Integra Connect, PrecisionQ.

Lung cancer is one of the most commonly diagnosed types of cancers, with the majority categorized as non-small cell lung cancer (NSCLC).[1] Approximately 30–40% of NSCLC patients present with metastatic disease (mNSCLC) at the time of diagnosis,[2] with the tumors most often attached to the bones, liver, and brain. This stage of NSCLC has no cure and is associated with poor quality of life and a 5-year survival rate of less than 10 percent.[3]

Current mNSCLC guidelines recommend testing for driver mutations before treatment initiation. EGFR mutation is the most common genetic change detected in patients with mNSCLC,[4] and fortunately there are treatments available to target these mutations, with many drugs supported by robust evidence related to patient outcomes and survival.

Yet, genomic testing remains inconsistent – an alarming trend given evidence has shown that overall survival (OS) improved when patients initiated treatment only after their EGFR test results and an appropriate treatment selected. Our recent study “Predictors of Epidermal Growth Factor (EGFR) Testing among Patients with Metastatic Non-Small Cell Lung Cancer (mNSCLC) treated in the Real-World Setting” presented at ISPOR 2023 aimed to understand the factors associated with EGFR testing before treatment initiation.

The study – using the Integra Connect de-identified data set — uncovered three trends for life sciences, payers and providers to note (download the study):

  • Asian American patients have a decreased likelihood of testing for EGFR prior to treatment initiation. This is alarming given people of Asian ancestry are at a higher risk than other patient populations of developing mNSCLC due to EGFR changes.[5]
  • Those with squamous cell histology have a lower rate of EGFR testing compared to other histologies, an unfortunate trend given squamous cell carcinomas make-up less than 25% of tumors.[6] 
  • Non-smokers are more likely to get tested for EGFR prior to starting treatment. This is promising but an area for further attention given non-smoker Asian American women are twice as likely to develop lung cancer than female non-smokers of other ethnicities.[7] 

The data presented at ISPOR further underscores how real-world data (RWD) can help identify gaps in care, create evidence to support providers as they look to improve care quality, and spotlight opportunities to improve inclusivity and equitable access to the latest oncology advancements.

Of course, that work doesn’t stop with reviewing RWD. In order to address gaps in care it takes providers, life sciences companies, researchers, and payers working together to act on these findings. That’s why I work at Integra Connect: we transform data into knowledge and help the cancer care community embrace value-based, precision medicine.