Treatment strategy optimization for patients with non-small-cell lung cancer harboring EGFR mutation : a Delphi consensus
Isla, Dolores (Instituto de Investigación Sanitaria de Aragón)
De Castro Carpeño, Javier (Instituto de Investigación Sanitaria del Hospital Universitario La Paz)
García-Campelo, R. (Complejo Hospitalario Universitario de A Coruña)
Majem, Margarita (Institut d'Investigació Biomèdica Sant Pau)
Vicente, David (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Juan, Óscar (Hospital Universitari i Politècnic La Fe (València))

Data:	2021
Resum:	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.
Nota:	Altres ajuts: ICAPEM (Asociación para la Investigación de Cáncer de Pulmón en Mujeres).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Delphi ; Non-small-cell lung cancer ; Epidermal growth factor receptor ; Tirosine kinase inhibitors
Publicat a:	Clinical & translational oncology, Vol. 23 Núm. 7 (july 2021) , p. 1304-1313, ISSN 1699-3055

DOI: 10.1007/s12094-020-02518-0
PMID: 33210237

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