The following is a summary of “Assessing quality of care in early-stage resected stage non-small cell lung cancer (NSCLC): An evaluation of epidermal growth factor receptor (EGFR) testing and adjuvant (adj) therapy (tx).,” published in 2024 ASCO Annual Meeting under the issue of Oncology by Mulherin et al.

Before this study, osimertinib received FDA approval in December 2020 for treating EGFR-mutated NSCLC (exon 19 deletions/L858R) after tumor removal (stage IB-IIIA).

Researchers conducted a retrospective study using real-world data to investigate EGFR testing rates and osimertinib use in the adjuvant setting for patients with EGFR-mutated (EGFRm) stage IB-IIIA (ES) NSCLC.

They utilized the Integra Connect PrecisionQ database, encompassing over 3 million patients with cancer across 500 care sites; 803 patients were pinpointed in Stages IB to IIIA who underwent lung cancer resection (R) (December 1, 2021, and July 31, 2023). Evaluation encompassed adjuvant treatment across stages, overall and stage-specific EGFR testing rates, EGFR testing rates in adjuvant and non-adjuvant treatment groups, timing of EGFR testing, and treatment rates with an EGFR TKI among patients with EGFR mutation-positive. Descriptive analyses were applied, and proportions were compared using a chi-squared test.

The results showed the mean age of the 803 patients with ES R was 69 (SD = 8.3), with 53.3% female and 12% non-smokers. Adjuvant treatment was seen in 56% of patients with ES R, highest in Stage IIIA (70.2%) and lowest in Stage IB (31.7%) (P<0.001). The EGFR testing occurred in 70% of patients with ES R, with higher rates in adjuvant-treated (78%) than non-adjuvant-treated (59%) patients (P<0.001), EGFR testing varied across stages, highest in Stage IIB (76%) and lowest in Stage IB (60%) (P<0.001). The EGFR mutations were found in 10.4% of tested patients. Among patients with EGFR mutation-positive, 54% received EGFR TKI treatment, with the highest rates in Stage IIB (93%) (P<0.01). However, only 69% of patients with EGFR mutation-positive received adjuvant treatment; 78% received an EGFR TKI.

Investigators found that real-world data showed lower EGFR testing rates and osimertinib use in the adjuvant setting for eligible patients compared to the established benefits observed in the ADAURA trial.

Source: meetings.asco.org/abstracts-presentations/237856