Contribution of the idyllatm system to improving the therapeutic care of patients with nsclc through early screening of egfr mutations

Abstract

Epidermal growth factor receptor (EGFR) genotyping, a critical examen for the treatment decisions of patients with non-small cell lung cancer (NSCLC), is commonly assayed by next-generation sequencing (NGS), but this global approach takes time. To determine whether rapid EGFR genotyping tests by the Idylla™ system guides earlier therapy decisions, EGFR mutations were assayed by both the Idylla™ system and NGS in 223 patients with NSCLC in a bicentric prospective study. Idylla™ demonstrated agreement with the NGS method in 187/194 cases (96.4%) and recovered 20 of the 26 (77%) EGFR mutations detected using NGS. Regarding the seven missed EGFR mutations, five were not detected by the Idylla™ system, one was assayed in a sample with insufficient tumoral cells, and the last was in a sample not validated by the Idylla™ system (a bone metastasis). Idylla™ did not detect any false positives. The average time between EGFR genotyping results from Idylla™ and the NGS method was 9.2 ± 2.2 working days (wd) (12.6 ± 4.0 calendar days (cd)). Subsequently, based on the Idylla™ method, the timeframe from tumor sampling to the initiation of EGFR-TKI was 7.7 ± 1.2 wd (11.4 ± 3.1 cd), while it was 20.3 ± 6.7 wd (27.2 ± 8.3 cd) with the NGS method (p < 0.001). We thus demonstrated here that the Idylla™ system contributes to improving the therapeutic care of patients with NSCLC by the early screening of EGFR mutations.