OBJECTIVES Molecular diagnostics and care of non-small cell lung cancer (NSCLC) are continuously evolving. Few data document the current strategies to manage advanced NSCLC patients beyond progression in clinical practice. PATIENTS AND METHODS Be-TeaM is an Italian multi-center observational study conducted on consecutive EGFR-mutated stage IV NSCLC patients, progressed during/after a first-line EGFR-TKI. It consists of a retrospective phase, from first-line EGFR-TKI therapy start until study entry (i.e. beginning of the diagnostic process), and a prospective phase, until treatment choice or for 3 months if no therapy was prescribed. Primary objective was to describe the diagnostic and therapeutic approaches adopted after progression in a real-world setting. RESULTS Of 308 patients enrolled in 63 centers from July 2017 to June 2018, 289 were included in the analysis. In first line, 53.3 % received gefitinib, 32.5 % afatinib and 14.2 % erlotinib. The testing rate (i.e. rate of all patients undergone any biopsy -liquid and/or tissue- for the T790 M detection) was 90.7 %, with liquid biopsy being the most frequently executed. Of 262 biopsied patients, 64.5 % underwent only 1 liquid biopsy, 10.7 % only 1 tissue biopsy and 18.3 % >1 biopsy, both liquid and solid in 85.4 %. The T790M positivity rate was 45.3 %; of 166 patients undergone only a liquid biopsy and tested for the mutation, 39.8 % were T790M+ and 60.2 % T790M-/undetermined. By the observation end, 87.9 % patients had a post-progression treatment chosen, osimertinib being the most frequent among the T790M+. CONCLUSION Be-TeaM provides the first snapshot of current practices for the management of NSCLC patients beyond progression in Italy; in clinical practice, assessing the T790M status is not always feasible.

中文翻译：

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Be-TeaM：一项针对EGFR突变的NSCLC患者的二线治疗的意大利真实观察研究。

目的非小细胞肺癌（NSCLC）的分子诊断和护理正在不断发展。很少有数据记录目前用于治疗晚期NSCLC患者的策略，这些策略超出了临床实践的进展。患者与方法Be-TeaM是一项意大利多中心观察性研究，针对一线EGFR-TKI期间/之后进行的连续EGFR突变的IV期NSCLC患者进行。它包括回顾性阶段，从一线EGFR-TKI治疗开始到研究进入（即诊断过程的开始），以及前瞻性阶段，直到选择治疗，或者如果没有处方治疗，则为3个月。主要目的是描述在现实环境中进展后所采用的诊断和治疗方法。结果2017年7月至2018年6月，在63个中心招募了308名患者，分析中包括289个。在第一行中，有53.3％的人接受了吉非替尼，32.5％的阿法替尼和14.2％的厄洛替尼。测试率（即，所有接受过T790 M检测的活检（液体和/或组织）的患者的比率）为90.7％，其中液体活检是最常执行的检查。在262例活检患者中，有64.5％的患者仅进行了1次液体活检，只有10.7％的患者进行了1次组织活检和18.3％的> 1次活检，液体和固体均占85.4％。T790M阳性率为45.3％。在166名仅进行了液体活检并测试了突变的患者中，有39.8％的T790M +和60.2％的T790M- /未定。到观察结束时，已选择87.9％的患者进行了治疗后治疗，其中Oimertinib是T790M +中最常见的治疗方法。结论Be-TeaM提供了目前在意大利以外的NSCLC患者管理实践的第一张快照。在临床实践中，评估T790M的状态并不总是可行的。