Are you ordering EGFR testing on all patients with NSCLC after complete resection in light of ADAURA?
If patients do recur, do you perform these tests on the initial surgical specimen or on tissue from a fresh biopsy (or both?)
Answer from: Medical Oncologist at Academic Institution
Prior to FDA approval of adjuvant osimertinib, our team had not been ordering molecular diagnostics on people with stage I-III NSCLC as we viewed such testing as a poor use of medical and financial resources. About 70% of people with resected stage IA NSCLC will not recur, so there will never be a n...
Answer from: Medical Oncologist at Academic Institution
Yes. With our pathology colleagues we have established a policy of reflex molecular testing for all nonsquamous NSCLC patients (as well as PD-L1 expression by IHC for all histologies) at the time of diagnosis, regardless of stage. While this information does not currently ...
Answer from: Medical Oncologist at Academic Institution
Yes, our institution has a next-generation sequencing panel that I order for all patients with early stage lung cancer after complete resection. Based on ADAURA, we need to know EGFR mutation status for these patients and it is usually more cost-effective to perform an inclusive comprehensive molecu...
Answer from: Medical Oncologist at Academic Institution
This is a complicated question, but now with the option of adjuvant osimertinib, we do test all resected adenocarcinomas (and squamous cell carcinomas in nonsmokers) for EGFR mutations. For higher stage tumors, we will usually do a full mutation profiling with NGS or whole exome sequencing given the...
Answer from: Medical Oncologist at Academic Institution
Yes, I am. Based on the ADAURA study, I am getting mutational profiling, certainly including EGFR on all patients after complete resection. If one wanted to limit this a bit, one could perhaps order it only on patients that are nonsquamous and enhance the profiling in never smokers. I am also gettin...
Answer from: Medical Oncologist at Academic Institution
I am ordering EGFR mutational status on all patients with NSCLC, stage I-III, who have undergone surgical resection with curative intent. The ADAURA trial clearly demonstrated a substantial improvement in disease-free survival (DFS) for patients with stage IB-IIIA disease. The HR for improvement in ...