Cost-effectiveness of precision cancer medicine-current challenges in the use of next generation sequencing for comprehensive tumour genomic profiling and the role of clinical utility frameworks (Review).
comprehensive genomic profiling
cost effectiveness
next generation sequencing
precision cancer medicine
targeted therapy
Journal
Molecular and clinical oncology
ISSN: 2049-9469
Titre abrégé: Mol Clin Oncol
Pays: England
ID NLM: 101613422
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
03
07
2021
accepted:
30
08
2021
entrez:
15
12
2021
pubmed:
16
12
2021
medline:
16
12
2021
Statut:
ppublish
Résumé
Precision cancer medicine (PCM) is an emerging paradigm in oncology, which includes tumour comprehensive genomic profiling (CGP) to enable molecularly guided therapy. However, cost-effectiveness analyses of PCM are faced with several challenges and, thus, its cost-effectiveness remains unclear. Early trials using only molecularly guided therapy were faced with the challenge of providing adequate measures of outcome, which probably explains the modest treatment benefits demonstrated. Endpoints like the progression-free survival (PFS)2/PFS1 ratio may assist in overcoming this issue. Moreover, specific tumour subtypes appear to benefit more from PCM. Costs associated with next-generation sequencing (NGS) for CGP are decreasing, but targeted therapy itself represents a major cost driver. CGP not only enables prediction of response to treatment, but also resistance, and could thus prevent administration of unnecessary (and costly) therapies. In clinical practice, the presence of clinical frameworks, such as the Recommendations for the Use of NGS for Patients with Metastatic Cancers from the ESMO Precision Medicine Working Group, and the ESMO Scale for Clinical Actionability of Molecular Targets, are essential in appropriately identifying situations where PCM is clinically meaningful, thereby improving its cost-effectiveness.
Identifiants
pubmed: 34909199
doi: 10.3892/mco.2021.2453
pii: MCO-16-1-02453
pmc: PMC8655747
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
21Informations de copyright
Copyright © 2020, Spandidos Publications.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests.
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