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Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator
BACKGROUND: Adoption of high-throughput, gene panel-based, next-generation sequencing (NGS) into routine cancer care is widely supported, but hampered by concerns about cost. To inform policies regarding genomic testing strategies, we propose a simple metric, cost per correctly identified patient (C...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166172/ https://www.ncbi.nlm.nih.gov/pubmed/36961477 http://dx.doi.org/10.1093/oncolo/oyad005 |
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author | Stenzinger, Albrecht Cuffel, Brian Paracha, Noman Vail, Eric Garcia-Foncillas, Jesus Goodman, Clifford Lassen, Ulrik Vassal, Gilles Sullivan, Sean D |
author_facet | Stenzinger, Albrecht Cuffel, Brian Paracha, Noman Vail, Eric Garcia-Foncillas, Jesus Goodman, Clifford Lassen, Ulrik Vassal, Gilles Sullivan, Sean D |
author_sort | Stenzinger, Albrecht |
collection | PubMed |
description | BACKGROUND: Adoption of high-throughput, gene panel-based, next-generation sequencing (NGS) into routine cancer care is widely supported, but hampered by concerns about cost. To inform policies regarding genomic testing strategies, we propose a simple metric, cost per correctly identified patient (CCIP), that compares sequential single-gene testing (SGT) vs. multiplex NGS in different tumor types. MATERIALS AND METHODS: A genomic testing cost calculator was developed based on clinically actionable genomic alterations identified in the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets. Using sensitivity/specificity data for SGTs (immunohistochemistry, polymerase chain reaction, and fluorescence in situ hybridization) and NGS and marker prevalence, the number needed to predict metric was monetarized to estimate CCIP. RESULTS: At base case, CCIP was lower with NGS than sequential SGT for advanced/metastatic non-squamous non-small cell lung cancer (NSCLC), breast, colorectal, gastric cancers, and cholangiocarcinoma. CCIP with NGS was also favorable for squamous NSCLC, pancreatic, and hepatic cancers, but with overlapping confidence intervals. CCIP favored SGT for prostate cancer. Alternate scenarios using different price estimates for each test showed similar trends, but with incremental changes in the magnitude of difference between NGS and SGT, depending on price estimates for each test. CONCLUSIONS: The cost to correctly identify clinically actionable genomic alterations was lower for NGS than sequential SGT in most cancer types evaluated. Decreasing price estimates for NGS and the rapid expansion of targeted therapies and accompanying biomarkers are anticipated to further support NGS as a preferred diagnostic standard for precision oncology. |
format | Online Article Text |
id | pubmed-10166172 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-101661722023-05-09 Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator Stenzinger, Albrecht Cuffel, Brian Paracha, Noman Vail, Eric Garcia-Foncillas, Jesus Goodman, Clifford Lassen, Ulrik Vassal, Gilles Sullivan, Sean D Oncologist Cancer Diagnostics and Molecular Pathology BACKGROUND: Adoption of high-throughput, gene panel-based, next-generation sequencing (NGS) into routine cancer care is widely supported, but hampered by concerns about cost. To inform policies regarding genomic testing strategies, we propose a simple metric, cost per correctly identified patient (CCIP), that compares sequential single-gene testing (SGT) vs. multiplex NGS in different tumor types. MATERIALS AND METHODS: A genomic testing cost calculator was developed based on clinically actionable genomic alterations identified in the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets. Using sensitivity/specificity data for SGTs (immunohistochemistry, polymerase chain reaction, and fluorescence in situ hybridization) and NGS and marker prevalence, the number needed to predict metric was monetarized to estimate CCIP. RESULTS: At base case, CCIP was lower with NGS than sequential SGT for advanced/metastatic non-squamous non-small cell lung cancer (NSCLC), breast, colorectal, gastric cancers, and cholangiocarcinoma. CCIP with NGS was also favorable for squamous NSCLC, pancreatic, and hepatic cancers, but with overlapping confidence intervals. CCIP favored SGT for prostate cancer. Alternate scenarios using different price estimates for each test showed similar trends, but with incremental changes in the magnitude of difference between NGS and SGT, depending on price estimates for each test. CONCLUSIONS: The cost to correctly identify clinically actionable genomic alterations was lower for NGS than sequential SGT in most cancer types evaluated. Decreasing price estimates for NGS and the rapid expansion of targeted therapies and accompanying biomarkers are anticipated to further support NGS as a preferred diagnostic standard for precision oncology. Oxford University Press 2023-03-24 /pmc/articles/PMC10166172/ /pubmed/36961477 http://dx.doi.org/10.1093/oncolo/oyad005 Text en © The Author(s) 2023. Published by Oxford University Press. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com. |
spellingShingle | Cancer Diagnostics and Molecular Pathology Stenzinger, Albrecht Cuffel, Brian Paracha, Noman Vail, Eric Garcia-Foncillas, Jesus Goodman, Clifford Lassen, Ulrik Vassal, Gilles Sullivan, Sean D Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator |
title | Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator |
title_full | Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator |
title_fullStr | Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator |
title_full_unstemmed | Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator |
title_short | Supporting Biomarker-Driven Therapies in Oncology: A Genomic Testing Cost Calculator |
title_sort | supporting biomarker-driven therapies in oncology: a genomic testing cost calculator |
topic | Cancer Diagnostics and Molecular Pathology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166172/ https://www.ncbi.nlm.nih.gov/pubmed/36961477 http://dx.doi.org/10.1093/oncolo/oyad005 |
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