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From now on, the issue is to shorten the time to treatment. Here, we challenge two well-known rapid strategies for EGFR testing: the cartridge-based platform Idylla\u2122 (Biocartis) and a digital droplet PCR (ddPCR) approach (ID_Solution). To thoroughly investigate each testing performance, we selected a highly comprehensive cohort of 39 unique del19 (in comparison, the cbioportal contains 40 unique del19), and 9 samples bearing unique polymorphisms in exon 19. Additional L858R (N = 24), L861Q (N = 1), del19 (N = 63), and WT samples (N = 34) were used to determine clear technical and biological cutoffs. A total of 122 DNA samples extracted from formaldehyde-fixed samples was used as input. No false positive results were reported for either of the technologies, as long as careful droplet selection (ddPCR) was ensured for two polymorphisms. ddPCR demonstrated higher sensitivity in detecting unique del19 (92.3%, 36\/39) compared to Idylla (67.7%, 21\/31). However, considering the prevalence of del19 and L858R in the lung cancer population, the adjusted theranostic values were similar (96.51% and 95.26%, respectively). ddPCR performs better for small specimens and low tumoral content, but in other situations, Idylla is an alternative (especially if a molecular platform is absent).<\/jats:p>","DOI":"10.3390\/ijms242115684","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T11:57:56Z","timestamp":1698407876000},"page":"15684","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison and Validation of Rapid Molecular Testing Methods for Theranostic Epidermal Growth Factor Receptor Alterations in Lung Cancer: Idylla versus Digital Droplet PCR"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7171-0427","authenticated-orcid":false,"given":"Camille","family":"L\u00e9once","sequence":"first","affiliation":[{"name":"Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France"},{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"},{"name":"Cancer Research Center of Lyon, UMR INSERM 1052 CNRS 5286, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mence","family":"Guerriau","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France"},{"name":"CNRS UMR 5261, INSERM U 1315, LabEx DEVweCAN, Institut NeuroMyoG\u00e8ne (INMG), Pathophysiology and Genetics of the Neuron and Muscle (PGNM) Laboratory, Team Chromatin Dynamics, Nuclear Domains, Virus, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Chalabreysse","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France"},{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u00ebl","family":"Duruisseaux","sequence":"additional","affiliation":[{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"},{"name":"Cancer Research Center of Lyon, UMR INSERM 1052 CNRS 5286, 69008 Lyon, France"},{"name":"Respiratory Department and Early Phase, Louis Pradel Hospital, Hospices Civils de Lyon Cancer Institute, 69100 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Couraud","sequence":"additional","affiliation":[{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"},{"name":"Department of Pulmonology and Thoracic Oncology, Lyon Sud Hospital, 69495 Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Brevet","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France"},{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Paul","family":"Bringuier","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France"},{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-5262","authenticated-orcid":false,"given":"Delphine Aude","family":"Poncet","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tumor Molecular Biology Unit, Groupement Hospitalier Est, Hospices Civils de Lyon, 69394 Bron, France"},{"name":"University of Lyon, Universit\u00e9 Claude Bernard Lyon 1, 69100 Lyon, France"},{"name":"CNRS UMR 5261, INSERM U 1315, LabEx DEVweCAN, Institut NeuroMyoG\u00e8ne (INMG), Pathophysiology and Genetics of the Neuron and Muscle (PGNM) Laboratory, Team Chromatin Dynamics, Nuclear Domains, Virus, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer Incidence and Mortality Worldwide: Sources, Methods and Major Patterns in GLOBOCAN 2012","volume":"136","author":"Ferlay","year":"2015","journal-title":"Int. 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