Rapid and reliable testing for clinically actionable EGFR mutations in non-small cell lung cancer using the Idylla^TM platform: a real-world two-center experience in Greece

Limited information exists on epidermal growth factor receptor <i>(EGFR)</i> molecular epidemiology in Greece. Next-generation sequencing (NGS) is the recommended method for <i>EGFR</i> genotyping in NSCLC. The Idylla Biocartis platform is a fully automated system for actionable <i>EGFR</i> mutation detection. We describe the prevalence of EGFR mutations in NSCLC patients in two high-volume clinical centers in Greece and compare key methods used for their determination. Eight hundred and fifty-seven FFPE samples from NSCLC patients were tested for EGFR mutations at University of Crete (UoC; <i>n</i> = 324) and at Evangelismos Hospital, Athens (Evangelismos; <i>n</i> = 503). The prevalence of <i>EGFR</i> mutations was 11.1% in the whole cohort (11.5% in non-squamous). The detection rate was 11.0% by NGS, 9.8% by Sanger and 11.3% by Idylla for the whole cohort (12.0% in non-squamous). The agreement between Idylla and Sanger was 93.2%. A targetable <i>EGFR</i> mutation was detected in 10.0% using tissue NGS alone, and in 16.0% using concurrent Idylla ct<i>EGFR</i> testing. The frequency of <i>EGFR</i> mutations was as expected for a Caucasian population. The Idylla <i>EGFR</i> test performance is comparable to reference methods and with a shorter TAT. Adding a concurrent plasma Idylla test to tissue NGS testing increases the detection rate of <i>EGFR</i> mutations in NSCLC.