Treatment strategy optimization for patients with non-small-cell lung cancer harboring EGFR mutation: a Delphi consensus

Dolores Isla Casado; Javier de Castro Carpeño; María Rosario García Campelo; Margarita Majem; David Vicente Baz; Óscar Juan Vidal

Ayuda

Treatment strategy optimization for patients with non-small-cell lung cancer harboring EGFR mutation: a Delphi consensus

D. Isla ^[4] ; J. de Castro ^[1] ; R. García-Campelo ^[2] ; M. Majem ^[5] ; D. Vicente ^[3] ; O. Juan-Vidal ^[6]
1. [1] Hospital Universitario La Paz
  
  Hospital Universitario La Paz
  
  Madrid, España
2. [2] Complexo Hospitalario Universitario da Coruña
  
  Complexo Hospitalario Universitario da Coruña
  
  A Coruña, España
3. [3] Hospital Universitario Virgen Macarena
  
  Hospital Universitario Virgen Macarena
  
  Sevilla, España
4. [4] Hospital Universitario Lozano Blesa
5. [5] Hospital Santa Creu i Sant Pau
6. [6] Hospital Universitari i Politècnic La Fe
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Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 7 (July), 2021, págs. 1304-1313
Idioma: inglés
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Resumen
- Aim To stablish a consensus on the treatment strategy for advanced non–small-cell lung cancer (aNSCLC) with epidermal growth factor receptor mutation (EGFRm) in Spain.
  
  Methods After a systematic literature review, the scientific committee developed 33 statements in 4 fields: molecular diagnosis (10 items); histologic profile and patient clinical characteristics (7 items); first-line (1L) treatment in EGFRm aNSCLC (8 items); and subsequent-line treatment (8 items). A panel of 31 experts completed 2 Delphi online questionnaires rating their degree of agreement/disagreement for each statement through a 1–9 range scale (1–3 = disagree, 7–9 = agree). Consensus was reached if 2/3 of the participants are in the median range.
  
  Results In the first Delphi round consensus was achieved for 24/33 of the statements. One of the assertions was deleted, proceeding to a second round with the eight remaining questions with no consensus or in the range of indeterminacy. Determination of the EGFR status from tissue and analysis of the different biomarkers are two important variables that influenced treatment decision in patients with aNSCLC. 1L treatment should be the best therapeutic option, independently of the subsequent lines of treatment. For patients with the most common activating mutations osimertinib was considered the most efficient and safe 1L option. In case of disease progression, a new biopsy was needed.
  
  Conclusions A consensus document is proposed to optimize the treatment strategy for untreated patients with a NSCLC with EGFR sensitizing mutations.