Next generation sequencing in community oncology practice: Beneficial or economical burden?
| Autor: | Pablo M. Bedano, Radhika Walling, Shiroo Parshad, Arya Bolla, Janvi Bhatia, Anuj Krishna Agarwala, Gregory William Smith, Sumeet Bhatia, Mary Louise Mayer, Priti Poojary, Bilal Karim Siddiqui, Natraj Reddy Ammakkanavar |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Specific mutation business.industry medicine.medical_treatment Targeted therapy Clinical trial 03 medical and health sciences Exact test 030104 developmental biology 0302 clinical medicine Oncology 030220 oncology & carcinogenesis medicine Standard test Community practice Poor performance status Statistical analysis Intensive care medicine business |
| Zdroj: | Journal of Clinical Oncology. 35:102-102 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2017.35.15_suppl.102 |
| Popis: | 102 Background: Precision genomics medicine is a fast growing in cancer care. Targeted therapy has yielded substantial benefit when appropriately used. With next generation sequencing (NSG) use increasing in non-academic setting outside clinical trial, we need to consider benefits and economical burden of this. Methods: Retrospective chart analysis of cancer patients (pts) treated at a large community practice was undertaken. With IRB approval, demographic, clinical and NSG data were collected for 209 pts who had NSG in 2015 and 2016. Pts were placed in 1 of 4 categories based on NSG results with available drug for specific mutation and change in management (CIM): a) CIM for current, b) Potential to CIM with subsequent therapy, c) No CIM due to poor performance status, d) No CIM due to lack of new target and/or drug. Alternate economical standard test for the mutation noted. Statistical analysis was done using chi-square and fisher’s exact test. Results: Median age was 64yr. Most common tumor types tested where as listed in table 96% had stage 4 disease. 82% had ≥1 prior systemic therapy. Pts were assigned to categories as per table below. When RAS mutation status where accounted by standard testing, none of the colon cancer pts benefited from NSG test. 6 of 54 pts who had CIM had alternate test option. Financial responsibility for these tests is approximately $1.21 million. 18 pts in 2015 and 17 pts in 2016 where billed for test after exhausting insurance and support option. More financial data may be available at time of presentation. Conclusions: NGS tumor test might benefit small group of selective pts at time of testing. It is likely not prime time to use for colon cancer. Benefits with later therapy are difficult to predict. NSG should be used more judiciously due to financial implications. [Table: see text] |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|