title: Patients with Non-small Cell Lung Cancer Analyzed for EGFR: Adherence to Guidelines, Prevalence and Outcome.
abstract: BACKGROUND
  Epidermal growth factor receptor (EGFR) analysis is the first molecular test introduced in the routine care of patients with non-small cell lung cancer (NSCLC). In the present study, we describe the prevalence of EGFR mutations and the adherence to testing and treatment guidelines in a population-based Swedish NSCLC cohort.
  
  
  METHODS
  Patients with NSCLC analyzed for EGFR mutations were identified and their characteristics and survival data were retrieved. We compared the study cohort to a matched lung cancer population.
  
  
  RESULTS
  The EGFR mutation frequency was 10%. Mutations were enriched in women and in adenocarcinoma cases. Out of patients with advanced-stage NSCLC with non-squamous histology, only 49% were referred for EGFR analysis. Out of the patients with EGFR mutation and advanced disease, only 38% received EGFR-tyrosine kinase inhibitor (TKI) in first-line therapy.
  
  
  CONCLUSIONS
  The EGFR-mutated NSCLC population studied is similar to other Western populations. Surprisingly, a large proportion of patients were not referred for EGFR analysis. Out of the patients with EGFR mutation, fewer than 40% received EGFR-TKI as first-line treatment. Our results highlight the need for follow-up of treatment and diagnostic algorithms in routine healthcare.
authors.affiliation: Department of Medical Sciences, Respiratory Medicine, Uppsala University, Uppsala, Sweden martin.sandelin@medsci.uu.se.
authors.forename: Martin
authors.initials: M
authors.lastname: Sandelin
authors.affiliation: Regional Cancer Center Uppsala-Örebro, Uppsala, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Berglund
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden Unit of Molecular Pathology, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Sundström
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden Unit of Molecular Pathology, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Patrick
authors.initials: P
authors.lastname: Micke
authors.affiliation: Section of Oncology, Department of Radiology, Oncology and Radiation Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Simon
authors.initials: S
authors.lastname: Ekman
authors.affiliation: Department of Oncology, Gävle Hospital, Gävle, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Bergqvist
authors.affiliation: Department of Oncology, Gävle Hospital, Gävle, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Bergström
authors.affiliation: Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden Centre for Research and Development Uppsala University/County Council of Gävleborg, Gävle, Sweden.
authors.forename: Hirsh
authors.initials: H
authors.lastname: Koyi
authors.affiliation: Department of Respiratory Medicine, Gävle Hospital, Gävle, Sweden Centre for Research and Development Uppsala University/County Council of Gävleborg, Gävle, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Brandén
authors.affiliation: Department of Medical Sciences, Respiratory Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Janson
authors.affiliation: Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden Unit of Molecular Pathology, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Botling
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000378:metabolism; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000378:metabolism*; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000187:drug effects; D015995:Prevalence; D047428:Protein Kinase Inhibitors / Q000494:pharmacology
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: EGFR; Non-small cell lung cancer; mutation; outcome; population; prevalence