ESMO expert consensus statements on the management of EGFR mutant non-small-cell lung cancer

A Passaro; N Leighl; F Blackhall; S Popat; K Kerr; M J Ahn; M E Arcila; O Arrieta; D Planchard; F de Marinis; A M Dingemans; R Dziadziuszko; C Faivre-Finn; J Feldman; E Felip; G Curigliano; R Herbst; P A Jänne; T John; T Mitsudomi; T Mok; N Normanno; L Paz-Ares; S Ramalingam; L Sequist; J Vansteenkiste; I I Wistuba; J Wolf; Y L Wu; S R Yang; J C H Yang; Y Yatabe; G Pentheroudakis; S Peters

doi:10.1016/j.annonc.2022.02.003

ESMO expert consensus statements on the management of EGFR mutant non-small-cell lung cancer

Ann Oncol. 2022 May;33(5):466-487. doi: 10.1016/j.annonc.2022.02.003. Epub 2022 Feb 14.

Authors

A Passaro¹, N Leighl², F Blackhall³, S Popat⁴, K Kerr⁵, M J Ahn⁶, M E Arcila⁷, O Arrieta⁸, D Planchard⁹, F de Marinis¹⁰, A M Dingemans¹¹, R Dziadziuszko¹², C Faivre-Finn¹³, J Feldman¹⁴, E Felip¹⁵, G Curigliano¹⁶, R Herbst¹⁷, P A Jänne¹⁸, T John¹⁹, T Mitsudomi²⁰, T Mok²¹, N Normanno²², L Paz-Ares²³, S Ramalingam²⁴, L Sequist²⁵, J Vansteenkiste²⁶, I I Wistuba²⁷, J Wolf²⁸, Y L Wu²⁹, S R Yang³⁰, J C H Yang³¹, Y Yatabe³², G Pentheroudakis³³, S Peters³⁴

Affiliations

¹ Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy. Electronic address: [email protected].
² Division of Medical Oncology/Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Canada.
³ Division of Cancer Sciences, The University of Manchester, Manchester, UK; Department of Medical Oncology, The Christie National Health Service (NHS) Foundation Trust, Manchester, UK.
⁴ National Heart and Lung Institute, Imperial College, London, UK; Lung Unit, Royal Marsden Hospital, London, UK; The Institute of Cancer Research, London, UK.
⁵ Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, UK.
⁶ Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
⁷ Department of Pathology, Molecular Diagnostics Service, Memorial Sloan Kettering Cancer Center, New York, USA.
⁸ Thoracic Oncology Unit, Instituto Nacional de Cancerología, Mexico City, Mexico.
⁹ Department of Medical Oncology, Gustave Roussy, Villejuif, France.
¹⁰ Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy.
¹¹ Department of Respiratory Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
¹² Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdansk, Poland.
¹³ The University of Manchester, Manchester Academic Health Science Centre, The Christie NHS Foundation Trust, Manchester, UK.
¹⁴ Lung Cancer Patient and Advocate, Co-Founder of EGFR Resisters Patient Group.
¹⁵ Department of Medical Oncology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain.
¹⁶ Department of Oncology and Hemato-Oncology, University of Milano, European Institute of Oncology IRCCS, Milan, Italy.
¹⁷ Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, USA.
¹⁸ Lowe Center for Thoracic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, USA.
¹⁹ Peter MacCallum Cancer Centre, Melbourne, Australia.
²⁰ Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
²¹ State Key Laboratory of Translational Oncology, Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region, Hong Kong, China.
²² Cell Biology and Biotherapy and Scientific Directorate, Istituto Nazionale Tumori, "Fondazione G.Pascale" IRCCS, Naples, Italy.
²³ Lung Cancer Clinical Research Unit, and Complutense University, Madrid, Spain.
²⁴ Department of Hematology and Medical Oncology, Winship Cancer Institute, Atlanta, Georgia.
²⁵ Department of Medicine, Massachusetts General Hospital, Boston, USA.
²⁶ Department of Respiratory Oncology, University Hospital KU Leuven, Leuven, Belgium.
²⁷ Department of Translational Molecular Pathology, Unit 951, The University of Texas MD Anderson Cancer Center, Houston, USA.
²⁸ Lung Cancer Group Cologne, Department I for Internal Medicine and Center for Integrated Oncology Cologne/Bonn, University Hospital Cologne, Cologne, Germany.
²⁹ Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangdong, China.
³⁰ The Institute of Cancer Research, London, UK.
³¹ Department of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Republic of China.
³² Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
³³ Department of Medical Oncology, University of Ioannina, Ioannina, Epirus, Greece.
³⁴ Oncology Department - CHUV, Lausanne University, Lausanne, Switzerland.

PMID: 35176458
DOI: 10.1016/j.annonc.2022.02.003

Abstract

The European Society for Medical Oncology (ESMO) held a virtual consensus-building process on epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancer in 2021. The consensus included a multidisciplinary panel of 34 leading experts in the management of lung cancer. The aim of the consensus was to develop recommendations on topics that are not covered in detail in the current ESMO Clinical Practice Guideline and where the available evidence is either limited or conflicting. The main topics identified for discussion were: (i) tissue and biomarkers analyses; (ii) early and locally advanced disease; (iii) metastatic disease and (iv) clinical trial design, patient's perspective and miscellaneous. The expert panel was divided into four working groups to address questions relating to one of the four topics outlined above. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel for further discussion and amendment before voting. This manuscript presents the recommendations developed, including findings from the expert panel discussions, consensus recommendations and a summary of evidence supporting each recommendation.

Keywords: EGFR; consensus; lung cancer; targeted therapy; testing; treatment.

Publication types

Practice Guideline

MeSH terms

Carcinoma, Non-Small-Cell Lung* / drug therapy
Carcinoma, Non-Small-Cell Lung* / genetics
Consensus
ErbB Receptors / genetics
Humans
Lung Neoplasms* / genetics
Lung Neoplasms* / therapy
Medical Oncology

Substances

EGFR protein, human
ErbB Receptors