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Review
. 2021 Sep 1:14:4671-4692.
doi: 10.2147/OTT.S313669. eCollection 2021.

Testing for EGFR Mutations and ALK Rearrangements in Advanced Non-Small-Cell Lung Cancer: Considerations for Countries in Emerging Markets

Mercedes L Dalurzo #  1 , Alejandro Avilés-Salas #  2 , Fernando Augusto Soares #  3 , Yingyong Hou #  4 , Yuan Li #  5 , Anna Stroganova #  6 , Büge Öz #  7 , Arif Abdillah #  8 , Hui Wan #  8 , Yoon-La Choi #  9
Affiliations
Review

Testing for EGFR Mutations and ALK Rearrangements in Advanced Non-Small-Cell Lung Cancer: Considerations for Countries in Emerging Markets

Mercedes L Dalurzo et al. Onco Targets Ther. .

Abstract

The treatment of patients with advanced non-small-cell lung cancer (NSCLC) in recent years has been increasingly guided by biomarker testing. Testing has centered on driver genetic alterations involving the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) rearrangements. The presence of these mutations is predictive of response to targeted therapies such as EGFR tyrosine kinase inhibitors (TKIs) and ALK TKIs. However, there are substantial challenges for the implementation of biomarker testing, particularly in emerging countries. Understanding the barriers to testing in NSCLC will be key to improving molecular testing rates worldwide and patient outcomes as a result. In this article, we review EGFR mutations and ALK rearrangements as predictive biomarkers for NSCLC, discuss a selection of appropriate tests and review the literature with respect to the global uptake of EGFR and ALK testing. To help improve testing rates and unify procedures, we review our experiences with biomarker testing in China, South Korea, Russia, Turkey, Brazil, Argentina and Mexico, and propose a set of recommendations that pathologists from emerging countries can apply to assist with the diagnosis of NSCLC.

Keywords: ALK testing; EGFR testing; FISH; immunohistochemistry; next-generation sequencing; non-small-cell lung cancer.

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Conflict of interest statement

MD reports personal fees, non-financial support for speaker honoraria and/or congress travel assistance from Pfizer, Takeda, and Roche, outside the submitted work. AA and HW are employees of Takeda Pharmaceuticals International AG – Singapore Branch. The authors report no other conflicts of interest in this work.

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