Cost Analysis of Noninvasive Blood-Based MicroRNA Testing Versus CT Scans for Follow-up in Patients With Testicular Germ-Cell Tumors

Charytonowicz, Daniel; Aubrey, Harry; Bell, Chantelle; Ferret, Maeline; Tsui, Keith; Atfield, Rachel; Murray, Matthew J.; Wilson, Ed

doi:10.1016/j.clgc.2019.03.015

Cited by 29 publications

(15 citation statements)

References 36 publications

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“…First, this could decrease the need of imaging scans on surveillance, leading to reduced exposure to ionizing radiation from CT scans, and reduced costs, particularly if MRI is employed. A health economic analysis estimated that miR-371a-3p could reduce follow-up costs by 44%, namely, by reducing the amount of imaging in microRNA-negative cases [34]. Second, and most importantly, it may open a window for earlier treatment of relapses, which could be less morbid than waiting until conventional clinical relapse detection.…”

Section: Discussionmentioning

confidence: 99%

Utility of Serum miR-371a-3p in Predicting Relapse on Surveillance in Patients with Clinical Stage I Testicular Germ Cell Cancer

Lobo

Leão

Gillis

et al. 2021

European Urology Oncology

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Section: Discussionmentioning

confidence: 99%

Utility of Serum miR-371a-3p in Predicting Relapse on Surveillance in Patients with Clinical Stage I Testicular Germ Cell Cancer

Lobo

Leão

Gillis

et al. 2021

European Urology Oncology

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“…Novel methodologies may be of use in the future, such as digital droplet PCR and next generation sequencing, which could overcome eventual unspecificity of the assays used, however, the RT-qPCR pipeline validated thus far is attractive for implementation in the clinic, since it represents a relatively low-cost and fast method for testing several patient samples in time, providing clinicians with valuable information. A recent health economic analysis estimated that miR-371a-3p could reduce the costs with germ cell tumor patients follow-up strategy by as much as 44%, especially at the expense of reducing the amount of necessary imaging in microRNA-negative cases [41]. The value of this standardized pipeline relies on appropriate quality control and normalization [23,29].…”

Section: Introductionmentioning

confidence: 99%

Identification and Validation Model for Informative Liquid Biopsy-Based microRNA Biomarkers: Insights from Germ Cell Tumor In Vitro, In Vivo and Patient-Derived Data

Lobo

Gillis

Berg

et al. 2019

Cells

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Liquid biopsy-based biomarkers, such as microRNAs, represent valuable tools for patient management, but often do not make it to integration in the clinic. We aim to explore issues impeding this transition, in the setting of germ cell tumors, for which novel biomarkers are needed. We describe a model for identifying and validating clinically relevant microRNAs for germ cell tumor patients, using both in vitro, in vivo (mouse model) and patient-derived data. Initial wide screening of candidate microRNAs is performed, followed by targeted profiling of potentially relevant biomarkers. We demonstrate the relevance of appropriate (negative) controls, experimental conditions (proliferation), and issues related to sample origin (serum, plasma, cerebral spinal fluid) and pre-analytical variables (hemolysis, contaminants, temperature), all of which could interfere with liquid biopsy-based studies and their conclusions. Finally, we show the value of our identification model in a specific scenario, contradicting the presumed role of miR-375 as marker of teratoma histology in liquid biopsy setting. Our findings indicate other putative microRNAs (miR-885-5p, miR-448 and miR-197-3p) fulfilling this clinical need. The identification model is informative to identify the best candidate microRNAs to pursue in a clinical setting.

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“…Costs (in American dollars) for relevant tests and interventions were derived from previous cost analysis reports in patients with GCTs (Table 1) [21,22]. Total cost per patient was the sum of all costs until the patient was cured or died; miRNA371a‐3p cost was added to each outcome in the decision tree model for the Marker arm (Fig.…”

Section: Methodsmentioning

confidence: 99%

Impact of circulating microRNA test (miRNA‐371a‐3p) on appropriateness of treatment and cost outcomes in patients with Stage I non‐seminomatous germ cell tumours

et al. 2020

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Objectives To determine whether utilisation of a serum microRNA (miRNA) test could improve treatment appropriateness and cost‐effectiveness for patients with Stage I non‐seminomatous germ cell tumours (NSGCTs). Patients and Methods A decision tree model was built to investigate treatment course, clinical and cost outcomes for patients with Stage IA (T1N0M0S0) and IB (T2–4N0M0S0) NSGCT. The model compared outcomes and cost of standard approach using histopathology, conventional serum tumour markers and radiographic staging (standard model) to a miRNA‐based approach using the standard model + post‐orchidectomy serum miR‐371a‐3p (marker model). Probabilities of expected treatment and outcomes were based on presence/absence of cancer upon entering into the model. Overtreatment was defined as adjuvant chemotherapy or primary retroperitoneal lymph node dissection in a patient without cancer. Undertreatment was defined as initial surveillance for a patient with cancer. Results Utilising the miRNA marker‐based approach, 26% of patients avoid overtreatment and 8% avoid undertreatment in Stage IA NSGCT; 27% avoid overtreatment and 23% avoid undertreatment in Stage IB disease. Appropriate treatment decision‐making increased from 65% to 94% and 50% to 92% for Stage IA and IB, respectively. The miRNA‐based approach remained cost‐effective over a wide range of performance characteristics with savings of ~$1400 (American dollars)/patient for both Stage IA and IB disease. Conclusion A miRNA‐based approach may potentially select patients with Stage I NSGCT for correct treatment in a cost‐effective manner. Identification of residual teratoma‐only remains an issue. Prospective studies are necessary to validate these findings.

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Cost Analysis of Noninvasive Blood-Based MicroRNA Testing Versus CT Scans for Follow-up in Patients With Testicular Germ-Cell Tumors

Cited by 29 publications

References 36 publications

Utility of Serum miR-371a-3p in Predicting Relapse on Surveillance in Patients with Clinical Stage I Testicular Germ Cell Cancer

Utility of Serum miR-371a-3p in Predicting Relapse on Surveillance in Patients with Clinical Stage I Testicular Germ Cell Cancer

Identification and Validation Model for Informative Liquid Biopsy-Based microRNA Biomarkers: Insights from Germ Cell Tumor In Vitro, In Vivo and Patient-Derived Data

Impact of circulating microRNA test (miRNA‐371a‐3p) on appropriateness of treatment and cost outcomes in patients with Stage I non‐seminomatous germ cell tumours

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