NSCLC next generation sequencing associated with gains in life-years, reduced cost
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A simulated model demonstrated that using next generation sequencing compared with single gene testing potentially leads to large gains in life-years at a reduced cost per life-year gained for patients with nonsquamous non-small cell lung cancer.
According to the abstract presented at ASCO, the actionable driver oncogenes (ADOs) identified by next generation sequencing (NGS) include EGFR, ALK, ROS1, BRAF, RET, MET and NTRK, whereas the ADOs identified by single gene testing (SGT) only include EGFR and ALK.
“The current levels of testing for all of these beyond things like EGFR mutations or ALK gene fusions is dismal,” Nathan A. Pennell, MD, PhD, medical oncologist at the Cleveland Clinic and associate professor medical oncology at the Cleveland Clinic Lerner College, told Healio. “Also, what we illustrated with our model is that if we were to test every patient who is eligible for testing, identify them with targetable genetic alterations, and treat them, that the gain in life-years for these patients and the incremental cost for that gain in life-years is incredibly affordable.”
The researchers simulated different levels of SGT or NGS testing, which showed an additional 2,630 life-years gained (LYG) with every incremental 10% increase of NGS instead of SGT. Moreover, they reported that the cost savings per LYG could range from –$49 to –$109.
The current testing rate in the United States for SGT is around 80%, according to the abstract. When the researchers simulated current SGT rates for NGS, it resulted in an additional 21,019 LYG and a reduced cost per LYG of –$599. When Pennell and colleagues increased the NGS testing rate from 80% to 100%, LYG increased by 15,017 over the current state. Further, the cost per LYG to identify, test and treat 100% of eligible patients with NGS would be $16,641.57.
“This is something that could be done today, if everyone in America who has the ability to influence genomic and genetic testing for lung cancer patients recognized that this is critically important and made an effort to do it for every eligible patient — this could happen tomorrow,” Pennell said. “We could be identifying, treating and potentially extending lives at a very reasonable cost, immediately.”
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Pennell NA, et al. Abstract 9529. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
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