The NHS in England and Wales finally has consensus on what tests can be used to determine if a lung cancer patient has the genetic mutation epidermal growth factor receptor (EGFR).
The National Institute for Health and Care Excellence (NICE) has produced guidance recommending several tests to detect the mutation, which is prevalent in between 10 to 15 per cent of Caucasian people with non-small cell lung cancer (NSLC) and 40 per cent of Asian people.
It is important to know if patients have the mutation as some treatments are more effective in this specific population.
These include Boehringer Ingelheim’s Giotrif/ Gilotrif (afatinib) and Roche’s Tarceva (erlotinib), both of which have specific approvals for use in patients with EGFR.
Both medicines were also approved by the US Food and Drug Administration (FDA) alongside companion diagnostics: Roche’s own cobas EGFR Mutation Test for Tarceva and Qiagen’s therascreen EGFR RGQ PCR Kit for Gilotrif.
Similar guidance has been lacking in Europe, but NICE has now made the effort to ensure appropriate patients are given access to these personalised treatments.
As such, both the Roche and Qiagen devices are recommended to detect EGFR in patients, although neither is suggested for use alongside a specific medicine.
“We know that patients whose tumours are positive for the EGFR mutation and who are given an EGFR-TK inhibitor gain more benefit than from standard chemotherapy treatment,” explained Professor Carole Longson, NICE Health Technology Evaluation Centre director.
“We also know that patients without the EGFR mutation do not respond as well if they are given these drugs instead of standard chemotherapy.
“It is important, therefore, to ensure high accuracy of testing, particularly to minimise the chances of incorrect treatment as a result of a false-positive or false-negative test results, in order to improve outcomes for patients with lung cancer.”