Study Substantiates Cost-Effectiveness of Biomarker-Based NSCLC Treatment

Multiplexed genetic screening for EGFR and ALK gene rearrangements and subsequent biomarker-guided treatment is cost-effective compared with standard chemotherapy treatment without any molecular testing in the metastatic NSCLC setting in the United States, researchers report in The Journal of Thoracic Oncology.

In NSCLC there are specific genetic abnormalities within the tumor that can be exploited with drugs specific for the molecular abnormality. These molecularly-guided or targeted-therapies have been shown to be effective for tumors with EGFR mutations and ALK rearrangements thus leading to approved drugs and guidelines for molecular testing. However, the presence of EGFR mutations and ALK rearrangements is low in unselected NSCLC, 9.5% and 3.9%, respectively. Likewise there is a cost associated with molecular testing and the question of whether to wait for molecular results or start chemotherapy immediately has led to complexity in treatment decision-making.

Researchers at Harvard University constructed a microsimulation model to compare life expectancy and costs of multiplexed EGFR and ALK testing followed by molecularly-guided therapy versus chemotherapy with no testing, chemotherapy until the testing results and switch to targeted-therapy, or a complete course of chemotherapy followed by targeted-therapy if indicated.

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