Precision Oncology

About Precision Oncology

The use of advanced molecular diagnostic technologies, such as the Next Generation Sequencing-based Genetic Panel (NGS), to select therapies targeted in patients with advanced cancer, is known as precision oncology.

The viability of this approach results from the confluence of emerging multiplexed molecular technologies and the rapidly expanding set of molecularly targeted therapies. While precision oncology represents an important paradigm of translational medicine, the associated clinical outcomes are still maturing.

We previously reported the results of a retrospective control study conducted to evaluate progression-free survival (PFS), and health costs among 72 patients with metastatic cancer of various subtypes.

This analysis found that the 36 patients who had received precision cancer treatment had longer periods of PFS than the 36 controls who received standard chemotherapy or better supportive care (22.9 weeks vs. 12.0 weeks) and that this difference was significant (P = 0.002).

In addition, a subset analysis of 44 patients who received all care within the Intermountain system found that the costs for those in the target treatment group had no higher costs than those in the control group (US $ 4,665 per week versus US $ 5,000 per week, p = 0.126).

Study Summary

In order to assess the impact of precision medicine for cancer in addition to the PFS window and determine the degree to which any survival or cost advantages persisted, we performed a follow-up analysis of the subgroup of 44 patients from the original study to measure overall survival, average total health care costs and resource utilization throughout the observation period from the beginning of the study to death or the last observed encounter.
The impact of precision oncology in guiding decisions to treat patients with advanced cancer has been previously studied in a retrospective analysis. However, overall survival and costs were not previously evaluated. We report the overall survival and medical costs associated with precision oncology in these patients with advanced cancer.

Based on a combined cohort study of 44 metastatic cancer patients who received all their care within a single institution, we assessed overall survival and health costs for each patient. We analyzed the results of 22 patients receiving genomic and targeted therapy (precision oncology) between July 1, 2013 and January 31, 2015 and compared to 22 historically controlled patients who received standard chemotherapy (N = 17) or better support (N = 5).

The average survival was 51.7 weeks for the target treatment group and 25.8 weeks for the control group (P = 0.008), when correspondence with age, sex, histological diagnosis and previous treatment lines. Mean costs over the entire period were $ 2,720 per week for the target treatment group and $ 3,453 per week for the control group (P = .036). A separate analysis of 1,814 patients with advanced cancer diagnoses found that those receiving targeted cancer treatment (N = 93) had 6.9% lower costs in the last 3 months of life compared to those who did not. 

These findings suggest that precision oncology can improve the overall survival of patients with refractory cancer and at the same time reduce average costs of medical care per week, resource utilization, and end-of-life costs.

To read the full study, click here.

Source: Oncotarget