Cost-comparison analysis of a multiplatform tumour profiling service to guide advanced cancer treatment

Abstract

Background Tumor profiling is increasingly used in advanced cancer patients to define treatment options, especially in refractory cases where no standard treatment is available. Caris Molecular Intelligence (CMI) is a multiplatform tumor profiling service that is comprehensive of next-generation sequencing (NGS) of DNA and RNA, immunohistochemistry (IHC) and in situ hybridisation (FISH). The aim of this study is to compare costs of CMI-guided treatment with prior or planned treatment options in correlation with outcome results. Methods Retrospective data from five clinical trials were collected to define the treatment decision prior to the receipt of the CMI report (n = 137 patients). A systematic review of treatment data from 11 clinical studies of CMI (n = 385 patients) allowed a comparison of planned vs actual (n = 137) and prior vs actual (n = 229) treatment costs. Results Treatment plan was changed in 88% of CMI-profiled cases. The actual CMI guided treatment cost per cycle was £995 in 385 treated patients. Planned treatment costs were comparable to actual treatment costs (£979 vs £945; p = 0.7123) and prior treatment costs were not significantly different to profiling-guided treatments (£892 vs £850; p = 0.631). Conclusions Caris Molecular Intelligence guided treatment cost per cycle was in the range of prior or planned treatment cost/cycle. Due to beneficial overall survival the additional cost of performing CMI’s multiplatform testing to the treatment costs seems to be cost-effective.

Impact and Diagnostic Gaps of Comprehensive Genomic Profiling in Real-World Clinical Practice

“…Overall, our study provides a real-world experience of the impact of CGP in a community-based academic NCI-designated cancer center serving a highly diverse patient population, where molecular testing is based on a two-tier testing algorithm. While recognizing that a 10% overall rate of management change that is based on CGP is very modest, its use in certain subsets, such as advanced NSCLC, where the impact currently is most significant appears to be justifiable and it has been found to be cost effective [40][41][42]. In addition, we have identified multiple reasons for the relatively smaller clinical impact of CGP in other tumor types, despite a much larger proportion of patients with actionable genomic alterations reported.…”

Biomarkers in Metastatic Colorectal Cancer: Status Quo and Future Perspective

“…However, while the clinical utility of single biomarkers, such as KRAS [205] and MSI-H/dMMR [10], have been proved to extend survival of CRC patients, the role of comprehensive molecular profiling remains largely questionable. Moreover, only a limited number of studies have investigated the cost-effectiveness of molecular profiling in cancer patients [206][207][208][209][210]. For instance, a study conducted in NSCLC patients showed that NGSbased parallel testing was more cost-effective than single-gene-based testing [207].…”

Non-small-cell lung cancer: how to manage MET exon 14 skipping mutant disease

“…Other commercial NGS panel tests interrogate both at the DNA and RNA level, like Caris. 45 Some NGS platforms combine DNA-based and RNA-based NGS panels in the same tissue sample, like the Oncomine Focus Assay 15 (ThermoFisher) as tested in the tepotinib VISION trial. Real-time PCR assays using RNA from tissue samples are currently in development; however, they have not yet been accepted or qualified to become companion diagnostic assays.…”