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Background  Before tyrosine kinase inhibitor (TKI) therapy can be administered in patients with advanced non‐small cell lung cancer (NSCLC),  EGFR  mutation testing is required. However, few studies have evaluated the extent of  EGFR  testing in real‐world practice in China.    Methods  A multicenter, observational study of  EGFR  testing in NSCLC patients in North China was conducted. Treatment‐naïve patients or those with postoperative recurrent stage IIIB/IV NSCLC were enrolled. The primary objective was  EGFR  testing rate. Secondary objectives included  EGFR  mutation status,  EGFR  testing methods and specimens, factors associated with  EGFR  testing, and overall survival with or without  EGFR  testing.    Results  Overall, 2809 patients with stage IIIB/IV NSCLC were enrolled; 90.78% had adenocarcinoma. The  EGFR  screening rate was 42.54%.  EGFR  testing rates were higher in tumor samples obtained by lymph node puncture, and in patients with urban medical insurance, adenocarcinoma, non‐smokers, or those located in developed cities (all  P  < 0.001). The  EGFR  mutation rate was 46.44%. The most commonly used specimens for  EGFR  testing were biopsy tumor samples (67.53%). PCR‐based methods (72.05%), Sanger sequencing (5.36%), and Luminex liquid chip (5.10%) were the most frequently used testing platforms. Similar positive  EGFR  mutation rates were achieved with different platforms. TKI therapy was the first‐line treatment administered to most  EGFR ‐positive patients (56.22%), and chemotherapy in  EGFR ‐negative patients (84.88%). Overall survival was higher in EGFR‐tested than in untested patients (27.50 vs. 19.73 months;  P  = 0.007).    Conclusion  Real‐world  EGFR  testing rates for NSCLC in North China were relatively low because of clinical and social factors, including medical insurance coverage.

Real‐world EGFR testing in patients with stage IIIB/IV non‐small‐cell lung cancer in North China: A multicenter, non‐interventional study