Reflex testing for mutations in patients with early-stage non-small cell lung cancer: practical implications from ADAURA

SUMMARY

Targeted therapies against activating EGFR mutations stood at the cradle of the personalised treatment revolution for patients with advanced non-small cell lung cancer (NSCLC). Since then, molecular testing for EGFR mutations and many other oncogenic drivers has become part of the routine diagnostic work-up for patients with advanced NSCLC. Recently, the phase III ADAURA trial showed that the EGFR TKI osimertinib also induces a significant overall survival benefit in the adjuvant treatment of patients with early-stage NSCLC, instigating a new wave in this personalised treatment revolution. Based on these results, routine EGFR mutation testing should be expanded to also include early-stage NSCLC patients. In this, a reflex testing strategy is preferred as it reduces turnaround times and standardises the ordering of biomarker tests to ensure that more patients are being tested.