Academic Journal
Exploring the Cost Effectiveness of a Whole-Genome Sequencing:Based Biomarker for Treatment Selection in Patients with Advanced Lung Cancer Ineligible for Targeted Therapy
| العنوان: | Exploring the Cost Effectiveness of a Whole-Genome Sequencing:Based Biomarker for Treatment Selection in Patients with Advanced Lung Cancer Ineligible for Targeted Therapy |
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| المؤلفون: | Mfumbilwa, Zakile A., Simons, Martijn J.H.G., Ramaekers, Bram, Retèl, Valesca P., Mankor, Joanne M., Groen, Harry J.M., Aerts, Joachim G.J.V., Joore, Manuela, Wilschut, Janneke A., Coupé, Veerle M.H. |
| المصدر: | Mfumbilwa , Z A , Simons , M J H G , Ramaekers , B , Retèl , V P , Mankor , J M , Groen , H J M , Aerts , J G J V , Joore , M , Wilschut , J A & Coupé , V M H 2024 , ' Exploring the Cost Effectiveness of a Whole-Genome Sequencing : Based Biomarker for Treatment Selection in Patients with Advanced Lung Cancer Ineligible for Targeted Therapy ' , Pharmacoeconomics , vol. 42 , no. 4 , pp. 419-434 . https://doi.org/10.1007/s40273-023-01344-w |
| سنة النشر: | 2024 |
| المجموعة: | University of Groningen research database |
| مصطلحات موضوعية: | Humans, Lung Neoplasms/drug therapy, Carcinoma, Non-Small-Cell Lung/drug therapy, Cost-Effectiveness Analysis, B7-H1 Antigen, Antineoplastic Agents, Immunological, Biomarkers, Tumor, Cost-Benefit Analysis |
| الوصف: | Objective: We aimed to perform an early cost-effectiveness analysis of using a whole-genome sequencing-based tumor mutation burden (WGS-TMB), instead of programmed death-ligand 1 (PD-L1), for immunotherapy treatment selection in patients with non-squamous advanced/metastatic non-small cell lung cancer ineligible for targeted therapy, from a Dutch healthcare perspective. Methods: A decision-model simulating individual patients with metastatic non-small cell lung cancer was used to evaluate diagnostic strategies to select first-line immunotherapy only or the immunotherapy plus chemotherapy combination. Treatment was selected using PD-L1 [A, current practice], WGS-TMB [B], and both PD-L1 and WGS-TMB [C]. Strategies D, E, and F take into account a patient’s disease burden, in addition to PD-L1, WGS-TMB, and both PD-L1 and WGS-TMB, respectively. Disease burden was defined as a fast-growing tumor, a high number of metastases, and/or weight loss. A threshold of 10 mutations per mega-base was used to classify patients into TMB-high and TMB-low groups. Outcomes were discounted quality-adjusted life-years (QALYs) and healthcare costs measured from the start of first-line treatment to death. Healthcare costs includes drug acquisition, follow-up costs, and molecular diagnostic tests (i.e., standard diagnostic techniques and/or WGS for strategies involving TMB). Results were reported using the net monetary benefit at a willingness-to-pay threshold of €80,000/QALY. Additional scenario and threshold analyses were performed. Results: Strategy B had the lowest QALYs (1.84) and lowest healthcare costs (€120,800). The highest QALYs and healthcare costs were 2.00 and €140,400 in strategy F. In the base-case analysis, strategy A was cost effective with the highest net monetary benefit (€27,300), followed by strategy B (€26,700). Strategy B was cost effective when the cost of WGS testing was decreased by at least 24% or when immunotherapy results in an additional 0.5 year of life gained or more for TMB high compared with TMB low. ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| DOI: | 10.1007/s40273-023-01344-w |
| الاتاحة: | https://hdl.handle.net/11370/c9879fcc-a041-438b-b170-ab402d22f0c1 https://research.rug.nl/en/publications/c9879fcc-a041-438b-b170-ab402d22f0c1 https://doi.org/10.1007/s40273-023-01344-w https://pure.rug.nl/ws/files/975533351/s40273-023-01344-w.pdf http://www.scopus.com/inward/record.url?scp=85181931820&partnerID=8YFLogxK |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.B1120320 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1007/s40273-023-01344-w |
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