Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 9;18(1):269.
doi: 10.1186/s12885-018-4023-4.

NSCLC molecular testing in Central and Eastern European countries

Ales Ryska  1 , Peter Berzinec  2 , Luka Brcic  3   4 , Tanja Cufer  5 , Rafal Dziadziuszko  6 , Maya Gottfried  7 , Ilona Kovalszky  8 , Włodzimierz Olszewski  9 , Buge Oz  10 , Lukas Plank  11 , Jozsef Timar  8
Affiliations

NSCLC molecular testing in Central and Eastern European countries

Ales Ryska et al. BMC Cancer. .

Abstract

Background: The introduction of targeted treatments for subsets of non-small cell lung cancer (NSCLC) has highlighted the importance of accurate molecular diagnosis to determine if an actionable genetic alteration is present. Few data are available for Central and Eastern Europe (CEE) on mutation rates, testing rates, and compliance with testing guidelines.

Methods: A questionnaire about molecular testing and NSCLC management was distributed to relevant specialists in nine CEE countries, and pathologists were asked to provide the results of EGFR and ALK testing over a 1-year period.

Results: A very high proportion of lung cancer cases are confirmed histologically/cytologically (75-100%), and molecular testing of NSCLC samples has been established in all evaluated CEE countries in 2014. Most countries follow national or international guidelines on which patients to test for EGFR mutations and ALK rearrangements. In most centers at that time, testing was undertaken on request of the clinician rather than on the preferred reflex basis. Immunohistochemistry, followed by fluorescent in situ hybridization confirmation of positive cases, has been widely adopted for ALK testing in the region. Limited reimbursement is a significant barrier to molecular testing in the region and a disincentive to reflex testing. Multidisciplinary tumor boards are established in most of the countries and centers, with 75-100% of cases being discussed at a multidisciplinary tumor board at specialized centers.

Conclusions: Molecular testing is established throughout the CEE region, but improved and unbiased reimbursement remains a major challenge for the future. Increasing the number of patients reviewed by multidisciplinary boards outside of major centers and access to targeted therapy based on the result of molecular testing are other major challenges.

Keywords: ALK rearrangements; Central eastern European region; EGFR mutations; Molecular testing; Non-small cell lung cancer.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Ethics Committee approval was not needed as the data are purely descriptive and epidemiological. Tables 3 and 5 include retrospective data on the results of prior routine diagnostic molecular testing; no patient level data are included and no additional procedures, tests or samples were required. All respondents were clearly informed that the information collected was to form the basis for a manuscript describing molecular testing for NSCLC in the CEE region.

Consent for publication

Not applicable.

Competing interests

AR reports receiving grants and personal fees from AstraZeneca and MSD, honoraria for advisory board participation AstraZeneca, MSD, Novartis, Boehringer Ingelheim and personal fees and honoraria for advisory board participation and lectures from BMS, outside the submitted work. PB reports receiving honoraria from AstraZeneca, Boehringer Ingelheim, Pfizer, MSD, and Roche, and has participated at advisory boards for Boehringer Ingelheim, Pfizer, and MSD. LB reports receiving personal fees from Roche, AstraZeneca, Pfizer, Boehringer Ingelheim, outside the submitted work. TC reports receiving consulting fees from Pfizer, Boehringer Ingelheim, BMS outside the submitted work. RD reports personal fees from Pfizer, Roche, AstraZeneca, Boehringer Ingelheim, Novartis, outside the submitted work. MG reports receiving consulting fees from Pfizer, Boehringer Ingelheim, BMS, MSD. IK reports receiving personal fees from Pfizer (participation in 2015 advisory board preparing the manuscript) related to the work under consideration. WO reports receiving honoraria or consulting fees from MSD, Boehringer Ingelheim, Pfizer and Abbott outside the submitted work. OB reports receiving consulting fees from Pfizer, Boehringer Ingelheim, BMS and MSD outside the submitted work. LP reports receiving grants from Slovak Research and Development Agency, Pfizer Slovakia, Ministry of Health Slovakia related to the work under consideration and grants from Novartis Slovakia, Takeda Slovakia, and AstraZeneca Slovakia outside the submitted work. JT reports receiving personal fees from BMS, Lilly, Pfizer, Roche, and Boehringer Ingelheim outside the submitted work. All authors report receiving financial support from Pfizer and non-financial support from SuccinctChoice Medical Communications (funded by Pfizer) related to the work under consideration.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Lung cancer subtypes by country. NE, neuroendocrine carcinoma; NOS, not otherwise specified; NSCLC, non-small cell lung cancer
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. GLOBOCAN . 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase no. 11. Lyon: International Agency for Research on Cancer; 2013.
    1. Kerr KM, Bubendorf L, Edelman MJ, Marchetti A, Mok T, Novello S, O'Byrne K, Stahel R, Peters S, Felip E. Second ESMO consensus conference on lung cancer: pathology and molecular biomarkers for non-small-cell lung cancer. Ann Oncol. 2014;25(9):1681–1690. doi: 10.1093/annonc/mdu145. - DOI - PubMed
    1. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, Beer DG, Powell CA, Riely GJ, Van Schil PE, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung Adenocarcinoma. J Thorac Oncol. 2011;6(2n):244–285. doi: 10.1097/JTO.0b013e318206a221. - DOI - PMC - PubMed
    1. Couraud S, Zalcman G, Milleron B, Morin F, Souquet PJ. Lung cancer in never smokers – a review. Eur J Cancer. 2012;48(9):1299–1311. doi: 10.1016/j.ejca.2012.03.007. - DOI - PubMed
    1. Black RC, Khurshid H. NSCLC: an update of driver mutations, their role in pathogenesis and clinical significance. R I Med J (2013) 2015;98(10):25–28. - PubMed

Publication types

Substances