Best of ASCO - 2014 Annual Meeting

 

Welcome

Attend this session at the
2018 ASCO Annual Meeting!


Session: Lung Cancer—Non-Small Cell Metastatic

Type: Poster Session

Time: Sunday June 3, 8:00 AM to 11:30 AM

Location: Hall A

Economic impact of next generation sequencing vs sequential single-gene testing modalities to detect genomic alterations in metastatic non-small cell lung cancer using a decision analytic model.

Sub-category:
Metastatic Non-Small Cell Lung Cancer

Category:
Lung Cancer—Non-Small Cell Metastatic

Meeting:
2018 ASCO Annual Meeting

Abstract No:
9031

Poster Board Number:
Poster Session (Board #354)

Citation:
J Clin Oncol 36, 2018 (suppl; abstr 9031)

Author(s): Nathan A. Pennell, Alex Mutebi, Zheng-Yi Zhou, Marie Louise Ricculli, Wenxi Tang, Helen Wang, Annie Guerin, Tom Arnhart, Kenneth W. Culver, Gregory Alan Otterson; Cleveland Clinic, Cleveland, OH; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Analysis Group, New York, NY; Analysis Group, Inc., Montreal, QC, Canada; Ohio State University, Columbus, OH

Abstract Disclosures

Abstract:

Background: Metastatic non-small cell lung cancer (mNSCLC) patients (pts) should be tested for genomic alterations (GA) to inform treatment decisions. This study assesses the economic impact of next generation sequencing (NGS) vs sequential single-gene testing modalities for Center for Medicare and Medicaid Services (CMS) Medicare and US commercial payers. Methods: In a decision analytic model, newly diagnosed mNSCLC pts were modeled to receive PD-L1 and GA tests (EGFR, ALK, ROS1, BRAF, MET, HER2, RET, NTRK1) using 1) sequential tests, 2) exclusionary mutation (KRAS) test followed by sequential tests 3) panel test or 4) upfront NGS, including all GAs and KRAS. Pts in modalities 1-3 were tested for GAs with currently approved treatment (EGFR, ALK, ROS1, BRAF) followed by single-gene tests or NGS for other GAs (e.g., HER2); a proportion were assumed to need rebiopsy. Inputs included turnaround time, unit costs and mNSCLC prevalence based on literature, public data and expert opinion. Time to receive results and total cost (test + rebiopsy) were calculated for each modality and compared with NGS. Results: For hypothetical 1 million-member plans, an estimated 2,066 CMS Medicare and 156 commercially insured mNSCLC pts would be tested for GA. Estimated time to receive results was 2.0 weeks for NGS and panel, 2.7 and 2.8 weeks faster than exclusionary and sequential, respectively. Using CMS reimbursement, NGS represented savings of $1,393,678 vs exclusionary, $1,530,869 vs sequential and $2,140,795 vs panel. For commercial payers, NGS remained the least expensive by $3,809 (vs exclusionary) to $250,842 (vs panel). Conclusions: Our model estimated that upfront NGS leads to the same (as panel) or shorter (vs exclusionary and sequential testing) wait time for results and the lowest payer cost to establish GA status for newly diagnosed mNSCLC pts to inform treatment decisions.

SequentialExclusionaryPanelNGS
CMS Medicare N = 2 066
Total cost3 721 3683 584 1774 331 2952 190 499
Savings with NGS1 530 8691 393 6782 140 795
Commercial N = 156
Total cost747 771624 178871 211620 369
Savings with NGS127 4023 809250 842

 
Other Abstracts in this Sub-Category:

 

1. Pembrolizumab (pembro) versus platinum-based chemotherapy (chemo) as first-line therapy for advanced/metastatic NSCLC with a PD-L1 tumor proportion score (TPS) ≥ 1%: Open-label, phase 3 KEYNOTE-042 study.

Meeting: 2018 ASCO Annual Meeting Abstract No: LBA4 First Author: Gilberto Lopes
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

2. Phase 3 study of carboplatin-paclitaxel/nab-paclitaxel (Chemo) with or without pembrolizumab (Pembro) for patients (Pts) with metastatic squamous (Sq) non-small cell lung cancer (NSCLC).

Meeting: 2018 ASCO Annual Meeting Abstract No: 105 First Author: Luis G. Paz-Ares
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

3. A comparative clinical study of PF-06439535, a candidate bevacizumab biosimilar, and reference bevacizumab, in patients with advanced non-squamous non-small cell lung cancer.

Meeting: 2018 ASCO Annual Meeting Abstract No: 109 First Author: Mark A. Socinski
Category: Lung Cancer—Non-Small Cell Metastatic - Metastatic Non-Small Cell Lung Cancer

 

More...