A Delphi consensus panel about clinical management of early-stage EGFR-mutated non-small cell lung cancer (NSCLC) in Spain: a Delphi consensus panel study

• Dolores Isla ^[5] ; Enriqueta Felip ^[1] ; Pilar Garrido ^[2] ; Amelia Insa ^[3] ; Margarita Majem ^[4] ; Jordi Remon ^[6] ; Jose M. Trigo ^[7] ; Javier de Castro ^[8]
  1. [1] Hospital Vall d'Hebron

     Hospital Vall d'Hebron

     Barcelona, España

     
  2. [2] Hospital Ramón y Cajal

     Hospital Ramón y Cajal

     Madrid, España

     
  3. [3] Hospital Clinico Universitario de Valencia

     Hospital Clinico Universitario de Valencia

     Valencia, España

     
  4. [4] Hospital de la Santa Creu i Sant Pau

     Hospital de la Santa Creu i Sant Pau

     Barcelona, España

     
  5. [5] Hospital Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
  6. [6] CIOCC HM Nou Delfos, Barcelona, España
  7. [7] HC Marbella-Hospital International, Málaga, España
  8. [8] Hospital Universitario La Paz-IDIPAZ, Madrid, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 1 (January), 2023, págs. 283-291
• Idioma: inglés
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• Resumen

  • Purpose This Delphi panel study assessed the level of consensus between medical oncologists on the clinical management of patients with early-stage EGFR-mutated non-small cell lung cancer (NSCLC).

    Methods A modified two-round Delphi approach was used. A scientific committee comprised of medical oncologists developed an online questionnaire. Delphi panel experts rated their level of agreement with each questionnaire statement on a 9-point Likert scale. The questionnaire included 36 statements from 3 domains (clinical management of early-stage NSCLC: 15 statements; role of adjuvant therapy in early-stage NSCLC: 9 statements; and role of adjuvant therapy in early-stage NSCLC with sensitizing EGFR mutation: 12 statements).

    Results In round 1, consensus was reached for 24/36 statements (66.7%). Nine statements that did not achieve consensus after the first round were evaluated in round 2, and none of them reached consensus. Overall, 84.4% of the panelists agreed that EGFR mutation testing should be done after surgery. Consensus was not achieved on whether the implementation of EGFR mutation testing in resected early-stage NSCLC could limit the use of adjuvant osimertinib. The panelists recognized the rationale for the use of osimertinib in the adjuvant scenario (88%) and 72% agreed that it may change the treatment paradigm in stage IB–IIIA EGFR-mutated NSCLC. Consensus was not reached on the inconvenience of prolonged duration of osimertinib.

    Conclusions This Delphi study provides valuable insights into relevant questions in the management of early-stage EGFR-mutated NSCLC. However, specific issues remain unresolved. The expert consensus emphasizes the role of adjuvant treatment with osimertinib in this scenario.