1. EGFR Audit at STHFT Ursula Earl, Kolanu Prasad, Sarah Nieman, Lisa Trimble, Mark Williams

2. Background  July 2010 NICE approve epidermal growth factor (EGFR) tyrosine kinase inhibitors (TKIs) for the treatment of advanced stage non small cell lung cancers  Testing on tumour tissue samples  NECN initially decide all NSCLC tumour types should be tested, revised to testing of selected NSCLC cases only after audit produced by Drs Ann Wadd & Naomi Chamberlin

3. AIMS  To determine the frequency of EGFR mutation positive non small cell lung cancers in a local population and to compare this frequency with results from other geographic regions.  To look at the impact of EGFR testing turnaround times on cancer waiting times.  To determine the completeness of EGFR SNOMED test results on the laboratory computer system.

4. Standards Evidence of Quality StandardExceptions % of EGFR mutation + non small cell lung cancers 10-20% Insufficient sample for testing EGFR test result SNOMED coded 100% Samples tested in Oct/Nov 2010 EGFR test turnaround time 7 days or less 0

5. Method – Data Collection  EGFR sample turnaround time from the lab “send away list” – EXCEL spreadsheet  LUCADA database  ILab SNOMED database

6. Time period  October 2010 – December 2010 All cases of NSCLC sent to Birmingham for testing  January 2011- September 2011 Selected NSCLC cases sent to Newgene for testing

7. Results - % positive Time period Oct-Dec 2010 Jan-Sept 2011 Testing lab BirminghamNewgene No of cases sent 22119 Test failed 15 Test + 47 % of cases + for EGFR mutation 19%6%

8. Results – TATs Oct – Dec 2010 TAT in days No of tests resulted % of results Cumulative % of tests resulted 1-7000 8-1431313 15-212922 22-28104568 >28731100

9. October – December 2010

10. Results – TATs Jan-Sept 2011 TAT in days No of tests resulted % of results Cumulative % of tests resulted 1-7544 8-14584953 15-21302578 22-28151291 >28108100

11. January – September 2011

12. Summary of results Evidence of Quality StandardResults Standard met? % of EGFR mutation + NSCLC 10-20% 19% - B 6% - N YesNo EGFR TAT Within 7 days 0% - B 4% - N No EGFR test result SNOMED coded on ILab 100%34%No