NICE recommends tests for lung cancer mutation

NICE has recommended a number of tests and test strategies to help doctors target treatments more effectively for people with non-small-cell lung cancer (NSCLC), the most common form of lung cancer.

A package of tests and test strategies have been endorsed by the cost watchdog as they have been deemed to be both clinically and cost effective in determining whether NSCLC patients carry a particular genetic mutation.

The genetic mutation can produce an enzyme – epidermal growth factor receptor-tyrosine kinase (EGFR-TK). Its presence therefore dictates how best to treat the patient with NSCLC as patients can either be treated with the most appropriate chemotherapy or one that stops the EGFR-TK mutation from working.

"We know that patients whose tumours are positive for the EGFR mutation and who are given an EGFR-TK inhibitor gain more benefit than from standard chemotherapy treatment. We also know that patients without the EGFR mutation do not respond as well if they are given these drugs instead of standard chemotherapy."

Professor Carole Longson, NICE Health Technology Evaluation Centre Director

NHS laboratories in England currently use tests to identify this mutation, however, there is no consensus on which laboratory test should be used.

"Based on the available evidence the independent Diagnostics Assessment Committee was able to recommend a number of tests for detecting EGFR-TK mutations as being clinically and cost effective options for informing first-line treatment decisions in patients with previously untreated, locally advanced or metastatic NSCLC in the NHS in England."

Professor Carole Longson, NICE Health Technology Evaluation Centre Director

NICE's approved tests include Roche Molecular Systems' cobas EGFR Mutation Test and Qiagen's therascreen EGFR RGQ PCR Kit.