The data, which comes from Ipsos Healthcare’s Global Oncology Monitor, shows that across three of the most highly-researched oncology biomarkers – HER2, KRAS and EGFR mutation – the proportion of relevant patients undergoing genetic testing in the UK was behind the EU4 average for the past few years. In fact, more often than not, the UK trailed each of the four individual markets.
Commenting on the reasons behind this variance, Amy Butcher, Director of Ipsos Healthcare’s Global Oncology Monitor, said:
“This delay in testing appears to be linked to delayed approval of the therapy associated with the biomarker – with the UK playing catch-up once approval has been granted.”
2012 data showed the UK finally catching up with the EU4 rate of testing for HER2 and EGFR mutation, yet still markedly behind in KRAS testing. Explained Butcher:
“The remarkably low UK testing rate in KRAS is a direct result of a negative NICE recommendation for the KRAS-related agents, Erbitux and Vectibix. This highlights the link between biomarker testing and product availability; in a case where no targeted therapy is available for use, testing is limited. Such delay in treatment availability can also help to explain the slower uptake of testing in lung and breast tumours, where the products of interest received delayed local approval in the UK.
“However, given the ability to access non-NICE approved therapies via the UK Cancer Drugs Fund (CDF) and the recent overhaul of the UK’s NHS system, it will be important to understand whether there is a reluctance to test in the UK, or if doctors are simply hampered by a lack of treatment availability. It may also be the case that there are other factors at play that impact testing decisions in the UK more so than in other markets.”
Encouragingly for the UK, Ipsos’ monitor also shows that once a patient is identified as ‘suitable’ via the testing process, the prescribing of the relevant product is in line with, or ahead of, that of other EU markets. In the case of mNSCLC, for example, in the last 12 months 95% of EGFR mutation-positive patients in the UK were prescribed one of the two products effective in this population – higher than in any other market.
Concluded Butcher, “This indicates that doctors are actively treating patients in the clinically accepted manner once suitable patients are identified.”
Ipsos European Oncology Monitor, 2005 – 2012, in UK, France, Germany, Italy and Spain:
Breast cancer patients undergoing HER2 testing (IHC or FISH): 4EU raw sample ranges from 5,396-6,973 patients from 200-312 doctors per year; UK raw sample ranges from 1,447-2,158 patients from 34-72 doctors per year.
2nd line metastatic colorectal cancer patients undergoing KRAS testing: 4EU raw sample ranges from 237-734 patients from 93-135 doctors per year; UK raw sample ranges from 43-234 patients from 14-23 doctors per year.
Metastatic non-small cell lung cancer patients (all histologies) undergoing EGFR mutation testing: 4EU raw sample ranges from 1,499-3,890 patients from 163-212 doctors per year; UK raw sample ranges from 398-803 patients from 28-42 doctors per year.
Source: Ipsos Healthcare