Authors' objectives: The objective of the technology review was to review the clinical effectiveness and diagnostic performance of EGFR mutation testing to detect the presence of EGFR mutations in patients with non-small cell lung cancer (NSCLC).

Authors' recommendations: There were fair to good level of evidence that suggest epidermal growth factor receptor (EGFR) mutation test contribute to the delivery of personalised cancer treatment plans by identifying the suitable patients for treatment with tyrosine kinase inhibitor with promising clinical effectiveness such as better overall response, overall survival and progression free survival. The evidence suggested that EGFR mutations were detected more frequently in women, non-smokers and in patients with histology result of adenocarcinoma. A variety of methods have demonstrated to be potential alternatives to the historical standard for EGFR mutation testing, namely direct sequencing. However, the only choice of the testing methods should base on local setting whether detection of known activating EGFR mutations only or all possible mutations is required, the availability of the equipment and laboratory's expertise, availability of sample and cost. In order to maximize the benefit of the EGFR mutation test for local population, proper selections of patients need to be taken into consideration as ethnicity, sex and smoking status were reported to be associated with EGFR mutation. There was one retrievable scientific evidence addressing the cost effectiveness of EGFR mutation testing and firstline treatment with Gefitinib for patients with advanced adenocarcinoma of the lung which was conducted in Singapore. It was reported that EGFR mutation-testing and first-line treatment with Gefitinib and second-line chemotherapy for EGFR mutation positive patients and chemotherapy followed by best supportive care for those with mutation negative shown to be a dominant strategy compared to no mutation testing and standard treatment with quality adjusted life years (QALYs) increase by 0.04 and costs decrease by SGD 2,400.

Project Status: Completed

Year Published: 2013

URL for published report: http://www.moh.gov.my/index.php/database_stores/store_view_page/30/222

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment (MaHTAS)