Currently Viewing:
Evidence-Based Oncology July 2017
Daratumumab With Standard Regimen Improves PFS, ORR Independent of Cytogenetic Risk in Multiple Myeloma
Surabhi Dangi-Garimella, PhD
Phase 1 Study Results at ASCO Support First-Line Use of Daratumumab in Multiple Myeloma
Surabhi Dangi-Garimella, PhD
Daratumumab-Based Combination Effective in Relapsed/Refractory Multiple Myeloma, Short PFS in Heavily Pretreated Patients
Surabhi Dangi-Garimella, PhD
Patient Selection Vital in Ensuring Improved Response to PD-1, PD-L1 Inhibitors in NSCLC
Surabhi Dangi-Garimella, PhD
An Early Stage Safety, Efficacy Study for Atezolizumab Plus Daratumumab in Advanced NSCLC
Surabhi Dangi-Garimella, PhD
LDH Levels Could Predict irAEs Associated With Checkpoint Inhibition and Radiotherapy in Lung Cancer
Surabhi Dangi-Garimella, PhD
Alectinib May Be a New Standard of Care for Treatment-Naïve ALK-Positive NSCLC
AJMC Staff
Dacomitinib a New First-Line Option for Advanced EGFR MutationŚPositive NSCLC
AJMC Staff
Androgen Deprivation, With or Without Radiotherapy, New Standard of Care in High-Risk Prostate Cancer
AJMC Staff
Trabectedin and Lurbinectedin Effective in BRCA2-Associated Metastatic Breast Cancer
AJMC Staff
HPV Vaccination May Lower Prevalence of Oropharyngeal Cancers in Young Adults
Surabhi Dangi-Garimella, PhD
Physical Activity, Healthy Diet Improve Survival in Colorectal Cancer: Study at ASCO
Surabhi Dangi-Garimella, PhD
Three Months of Oxaliplatin-Based Adjuvant Therapy Noninferior to 6 Months in Stage III Colon Cancer
AJMC Staff
Fas Biomarker Can Predict Response to Second-Line Therapy for Advanced Soft Tissue Sarcoma
AJMC Staff
Nivolumab, Alone or With Ipilimumab, Met the Disease Control Rate in Malignant Pleural Mesothelioma
AJMC Staff
Ibrutinib vs No Consolidation Are Being Compared Following Autologous HSCT in IRONCLAD Trial
AJMC Staff
Web-Based Patient Reporting of Symptoms Shown to Improve Survival in Patients With Metastatic Solid Tumors
AJMC Staff
Physician, Regulatory, and Payer Perspectives on the Value of Real-World Data
Surabhi Dangi-Garimella, PhD
Do We Have Adequate Surveillance in Cancer Care?
Surabhi Dangi-Garimella, PhD
MACRA 2.0 and Beyond: Preparing Your Practice to Meet the Quality and Reporting Challenges
Surabhi Dangi-Garimella, PhD
ASCO Study Finds Shift in Diagnosis Stage for Several Cancers Following ACA Implementation
Surabhi Dangi-Garimella, PhD
Switching Study Reports Equivalence Between Filgrastim, Biosimilar in Breast Cancer
Surabhi Dangi-Garimella, PhD
Research Demonstrates Efficacy and Safety of Trastuzumab Biosimilar SB3
Kelly Davio
CT-P6, a Trastuzumab Biosimilar, Shares the Safety and Efficacy Profile of Its Reference
Kelly Davio
Can the 4 Ps Devise Interventions to Reduce the Financial Toxicity of Cancer?
Surabhi Dangi-Garimella, PhD
Adjuvant Chemotherapy Reduces Cost, Improves Survival in NSCLC Post-Surgery
Surabhi Dangi-Garimella, PhD
Currently Reading
Brazilian Study Queries: Is NGS Cost-Effective in Advanced Lung Cancer?
Surabhi Dangi-Garimella, PhD

Brazilian Study Queries: Is NGS Cost-Effective in Advanced Lung Cancer?

Surabhi Dangi-Garimella, PhD
In a study presented at the 2017 American Society of Clinical Oncology Annual Metting, researchers from the Brazilian Cancer Foundation and the Brazilian National Cancer Institute evaluated the cost-effectiveness of a unique exam using next-generation sequencing versus other routine tests.
THE DEBATE OVER THE VALUE of using companion diagnostic tests in cancer care continues to hound providers and payers alike. Moving away from single-gene assays to gene panels, scientists are now grappling with deriving value from next-generation sequencing (NGS) as a companion diagnostic test.

NGS can sequence the entire genome or narrow down to specific areas of interest, such as the whole exome or specific genes. This is extremely important in the scenario of targeted therapy (1) to identify drugs that bring a patient response, (2) to avoid unnecessary toxicities, and (3) to reduce costs. The bottom line is proving the cost-effectiveness of NGS over other routinely used tests.

In this study, presented at the 2017 American Society of Clinical Oncology Annual Meeting, researchers from the Brazilian Cancer Foundation and the Brazilian National Cancer Institute evaluated the cost-effectiveness of a unique exam using NGS versus other routine tests, such as the ones that involve reverse transcription polymerase chain reaction and fluorescence in situ hybridization (FISH) analysis.

The target population for the study were patients with non–small cell lung cancer, adenocarcinoma, and candidates to first-line therapy, with mutations in the epidermal growth factor receptor (EGFR) or translocations in anaplastic lymphoma kinase (ALK) or ROS-1 genes. The testing strategy followed the below pattern:

Strategy 1: Test for EGFR mutation: if negative, FISH analysis for ALK; if FISH is negative, FISH for ROS-1.
Strategy 2: FISH analyses for ALK and ROS are requested together.
Strategy 3: NGS for all individuals (platform includes EGFR, ALK, ROS-1, and other genes).
 
The study was analyzed from a healthcare-payer perspective based on the Brazilian private sector. Cost estimates were based on 2016 data from diagnostic companies, ANS (National Regulatory Agency for Private Health Insurance and Plans) and AMB-CBHPM (Brazilian Medical Association). The authors found that the use of NGS increased both the cost and the rate of accurate mutations that were identified: 24% extra cases were rightly identified, and there was a simultaneous increase in treatment costs (US $800.76; 2015 purchasing power parity) attributed to the molecular testing. The incremental cost effectiveness ratio comparing NGS with sequential tests was US $3381.82 for every correct case detected. When the authors compared strategy 2 to 1, the ICER was US $937.86 for every correct case detected.

The study was founded on the effort to integrate companion diagnostics discussions on precision medicine and covered drugs in the Brazilian health system. “These findings can [subsidize] cost-effectiveness studies that incorporates subsequent treatments and survival,” the authors concluded.
REFERENCE

Schluckebier L, Caetano R, Aran V, Ferreira CGM. Cost-effectiveness analysis comparing companion diagnostic tests for EGFR, ALK and ROS-1 versus next-generation sequence (NGS) in advanced adenocarcinoma lung cancer patients. J Clin Oncol. 2017;35(suppl; abst 9068).
PDF
 
Copyright AJMC 2006-2017 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up
×

Sign In

Not a member? Sign up now!