EGFR testing and erlotinib use in non-small cell lung cancer patients in Kentucky

Kara L Larson; Bin Huang; Quan Chen; Thomas Tucker; Marissa Schuh; Susanne M Arnold; Jill M Kolesar

doi:10.1371/journal.pone.0237790

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EGFR testing and erlotinib use in non-small cell lung cancer patients in Kentucky

Journal article

Open access

Peer reviewed

EGFR testing and erlotinib use in non-small cell lung cancer patients in Kentucky

Kara L Larson, Bin Huang, Quan Chen, Thomas Tucker, Marissa Schuh, Susanne M Arnold and Jill M Kolesar

PloS one, Vol.15(8), e0237790

08/18/2020

DOI: 10.1371/journal.pone.0237790

PMCID: PMC7433873

PMID: 32810185

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Abstract

This study determined the frequency and factors associated with EGFR testing rates and erlotinib treatment as well as associated survival outcomes in patients with non small cell lung cancer in Kentucky. Data from the Kentucky Cancer Registry (KCR) linked with health claims from Medicaid, Medicare and private insurance groups were evaluated. EGFR testing and erlotinib prescribing were identified using ICD-9 procedure codes and national drug codes in claims, respectively. Logistic regression analysis was performed to determine factors associated with EGFR testing and erlotinib prescribing. Cox-regression analysis was performed to determine factors associated with survival. EGFR mutation testing rates rose from 0.1% to 10.6% over the evaluated period while erlotinib use ranged from 3.4% to 5.4%. Factors associated with no EGFR testing were older age, male gender, enrollment in Medicaid or Medicare, smoking, and geographic region. Factors associated with not receiving erlotinib included older age, male gender, enrollment in Medicare or Medicaid, and living in moderate to high poverty. Survival analysis demonstrated EGFR testing or erlotinib use was associated with a higher likelihood of survival. EGFR testing and erlotinib prescribing were slow to be implemented in our predominantly rural state. While population-level factors likely contributed, patient factors, including geographic location (areas with high poverty rates and rural regions) and insurance type, were associated with lack of use, highlighting rural disparities in the implementation of cancer precision medicine.

Mutation

United States

Administrative Claims, Healthcare - statistics & numerical data

Adult

Age Factors

Aged

Carcinoma, Non-Small-Cell Lung - drug therapy

Carcinoma, Non-Small-Cell Lung - genetics

Carcinoma, Non-Small-Cell Lung - mortality

DNA Mutational Analysis - economics

DNA Mutational Analysis - statistics & numerical data

Drug Prescriptions - economics

Drug Prescriptions - statistics & numerical data

Drug Utilization - economics

Drug Utilization - statistics & numerical data

ErbB Receptors - antagonists & inhibitors

ErbB Receptors - genetics

Erlotinib Hydrochloride - therapeutic use

Female

Genetic Testing - economics

Genetic Testing - statistics & numerical data

Healthcare Disparities - economics

Humans

Kentucky - epidemiology

Lung Neoplasms - drug therapy

Lung Neoplasms - genetics

Lung Neoplasms - mortality

Male

Medicaid - economics

Medicaid - statistics & numerical data

Medicare - economics

Medicare - statistics & numerical data

Middle Aged

Poverty - statistics & numerical data

Precision Medicine - economics

Precision Medicine - statistics & numerical data

Registries - statistics & numerical data

Retrospective Studies

Sex Factors

Survival Analysis

Young Adult

Details

Title: Subtitle: EGFR testing and erlotinib use in non-small cell lung cancer patients in Kentucky
Creators: Kara L Larson - University of Kentucky
Bin Huang - Markey Cancer Center
Quan Chen - Markey Cancer Center
Thomas Tucker - University of Kentucky
Marissa Schuh - Markey Cancer Center
Susanne M Arnold - University of Kentucky
Jill M Kolesar - University of Kentucky
Resource Type: Journal article
Publication Details: PloS one, Vol.15(8), e0237790
DOI: 10.1371/journal.pone.0237790
PMID: 32810185
PMCID: PMC7433873
ISSN: 1932-6203
eISSN: 1932-6203
Grant note: P30 CA177558 / NCI NIH HHS
Language: English
Date published: 08/18/2020
Academic Unit: Pharmacy; Pharmaceutical Sciences and Experimental Therapeutics
Record Identifier: 9984695792002771

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12 Times Cited - Web of Science

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