Understanding Molecular Testing Uptake Across Tumor Types in Eight Countries: Results From a Multinational Cross-Sectional Survey
- 11 March 2020
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in JCO Oncology Practice
- Vol. 16 (8), e770-e778
- https://doi.org/10.1200/jop.19.00507
Abstract
The growth in understanding of molecular biology and genomics has augmented the development of targeted cancer treatments; however, challenges exist in access to molecular testing, an essential precursor to treatment decision-making. We used data from a cross-sectional survey to evaluate the differences in uptake of molecular testing, Using the aggregated results of a questionnaire developed and distributed to clinicians by IQVIA, including treatment details and investigations undertaken for patients, we compared proportions of patients receiving molecular testing and targeted treatment by cancer type for the United Kingdom, France, Italy, Germany, Spain, South Korea, Japan, and China. We used multivariable logistic regression methods to understand the effect of country on the odds of receiving a molecular test. There was a total of 61,491 cases. Across countries and cancer types, uptake rates for molecular testing ranged between 2% and 98%, with the greatest differences seen in gastric cancers (range, 23% to 70%), and significant variations were observed for both European and Asian countries. China consistently demonstrated a significantly reduced uptake for all molecular tests assessed; however; uptake of drug treatment in gastric cancers after testing positive for the human epidermal growth factor receptor 2 gene was higher than in some European countries (China, 85%; European range, 8% to 66%). The uptake of epidermal growth factor receptor gene testing was greater in some Asian countries relative to the United Kingdom, where incidence of lung cancer is higher (Japan: odds ratio, 3.1 [95% CI, 2.6 to 3.8]; South Korea: odds ratio, 2.7 [95% CI, 2 to 3.4]). We have highlighted inequity in access to molecular testing and subsequent treatments across countries, which warrants improvements.Keywords
This publication has 25 references indexed in Scilit:
- The prevalence of EGFR mutation in patients with non-small cell lung cancer: a systematic review and meta-analysisOncotarget, 2016
- Challenges in molecular testing in non-small-cell lung cancer patients with advanced diseaseThe Lancet, 2016
- ESMO consensus guidelines for the management of patients with metastatic colorectal cancerAnnals of Oncology, 2016
- Cutaneous melanoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of Oncology, 2015
- Delivering precision medicine in oncology today and in future—the promise and challenges of personalised cancer medicine: a position paper by the European Society for Medical Oncology (ESMO)Annals of Oncology, 2014
- IMATINIB IN CHRONIC MYELOID LEUKEMIA: AN OVERVIEWMediterranean Journal of Hematology and Infectious Diseases, 2013
- Overcoming implementation challenges of personalized cancer therapyNature Reviews Clinical Oncology, 2012
- Personalized Medicine and CancerJournal of Personalized Medicine, 2012
- Adjuvant Trastuzumab in HER2-Positive Breast CancerThe New England Journal of Medicine, 2011
- KRAS Mutation Testing in the Treatment of Metastatic Colorectal Cancer with Anti-EGFR TherapiesCurrent Oncology, 2010