Precision Medicine Improves Survival in Late-Stage Cancer, Lowers Health Care Costs

03/21/18

Precision oncology strategies may improve overall survival (OS) for patients with refractory cancer while lowering the average per-week health care costs, resource utilization, and end-of-life costs.

Previous studies have examined the impact of precision oncology methods—such as next-generation sequencing-based gene panel testing—on guiding treatment decisions for patients with late-stage cancer. However, the resulting OS trends and associated costs of such methods have yet to be evaluated.

Lincoln D Nadauld, MD, Precision Genomics Program, Intermountain Healthcare (Saint George, UT), and Stanford University School of Medicine, and colleagues conducted a study to determine the OS and health care costs associated with precision oncology in patients with advanced cancer. Researchers utilized a matched cohort of 44 patients with metastatic cancer who received their care at a single institution from July 2013 through January 2015. Researchers compared data from 22 patients who received genomic testing and targeted therapy with data from 22 patients who received standard chemotherapy or best supportive care.

Results of the study were published in Oncotarget (February 2018;9:12316-12322).

After matching for age, gender, histological diagnosis, and previous treatment lines, researchers found that the median overall survival was 51.7 weeks for patients receiving targeted treatment after precision oncology compared with 25.8 weeks for patients receiving chemotherapy or supportive care (P = .008).

Average costs over the study period were $2720 per week for patients receiving targeted therapy compared with $3453 per week for those receiving chemotherapy or supportive care (P = .036).

In a separate analysis of 1814 patients with late-stage cancer, researchers found that those who received a targeted cancer treatment (n = 93) benefited from 6.9% lower inpatient costs in the last 3 months of life compared with those who received chemotherapy or supportive care.

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The simultaneous improvement in overall survival, as well as lower per-week costs, suggest that a precision medicine approach may be an attractive option for patients with refractory cancer,” Dr Nadauld and colleagues wrote.

A potential limitation of the study exists in the fact that all patients received treatment within a single integrated health care delivery system, which may hider these results from being generalized to overall population of patients with late-stage cancer, authors of the study acknowledged. Further studies are warranted to validate these findings.—Zachary Bessette